Healthcare Provider Details

I. General information

NPI: 1386952851
Provider Name (Legal Business Name): KEISHA FERREIRA MS, LCAS-REG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2010
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7711 COLLECTION RIVER DR #6102
RALEIGH NC
27617-8687
US

IV. Provider business mailing address

7711 COLLECTION RIVER DR #6102
RALEIGH NC
27617-8687
US

V. Phone/Fax

Practice location:
  • Phone: 919-633-5457
  • Fax:
Mailing address:
  • Phone: 919-633-5457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0718000282
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: