Healthcare Provider Details

I. General information

NPI: 1467712141
Provider Name (Legal Business Name): JOEL FERAT MSW, LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2012
Last Update Date: 09/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 GOULD ST
NEEDHAM MA
02494-2397
US

IV. Provider business mailing address

2712 N LEHMANN CT #4S
CHICAGO IL
60614-9208
US

V. Phone/Fax

Practice location:
  • Phone: 774-225-0036
  • Fax:
Mailing address:
  • Phone: 617-942-0588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.015098
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: