Healthcare Provider Details

I. General information

NPI: 1861319303
Provider Name (Legal Business Name): THOMAS ROSS FERRA LLPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42364 SHULOCK DR
CLINTON TOWNSHIP MI
48038-6428
US

IV. Provider business mailing address

42364 SHULOCK DR
CLINTON TOWNSHIP MI
48038-6428
US

V. Phone/Fax

Practice location:
  • Phone: 586-610-8402
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6451025111
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: