Healthcare Provider Details

I. General information

NPI: 1437833175
Provider Name (Legal Business Name): LARYIA KRISTEN FERRIE LLMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2023
Last Update Date: 06/13/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5303 S CEDAR ST STE 2
LANSING MI
48911-3800
US

IV. Provider business mailing address

7018 N RIVER HWY
GRAND LEDGE MI
48837-9387
US

V. Phone/Fax

Practice location:
  • Phone: 517-346-8000
  • Fax:
Mailing address:
  • Phone: 517-512-9274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851116839
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: