Healthcare Provider Details

I. General information

NPI: 1962070656
Provider Name (Legal Business Name): FERRIS CLARE LPCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2021
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9175 GUILFORD RD
COLUMBIA MD
21046-1802
US

IV. Provider business mailing address

9175 GUILFORD RD
COLUMBIA MD
21046-1802
US

V. Phone/Fax

Practice location:
  • Phone: 203-428-4587
  • Fax:
Mailing address:
  • Phone: 203-428-4587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4751
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5223
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: