Healthcare Provider Details

I. General information

NPI: 1992161657
Provider Name (Legal Business Name): ALICE MARIE FERREE MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2016
Last Update Date: 08/31/2024
Certification Date: 08/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1585 3RD ST
FORT JOHNSON LA
71459-5102
US

IV. Provider business mailing address

1585 3RD ST
FORT JOHNSON LA
71459-5102
US

V. Phone/Fax

Practice location:
  • Phone: 337-531-3517
  • Fax: 337-531-3175
Mailing address:
  • Phone: 337-531-3517
  • Fax: 337-531-3175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.017772
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: