Healthcare Provider Details

I. General information

NPI: 1326786831
Provider Name (Legal Business Name): AMANDA DANIELLE FERRARI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMANDA PIERSON

II. Dates (important events)

Enumeration Date: 05/24/2022
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2104 W ROSCOE ST
CHICAGO IL
60618-6220
US

IV. Provider business mailing address

2104 W ROSCOE ST
CHICAGO IL
60618-6220
US

V. Phone/Fax

Practice location:
  • Phone: 773-340-0037
  • Fax:
Mailing address:
  • Phone: 773-340-0037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149026002
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150105439
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150.105439
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: