Healthcare Provider Details

I. General information

NPI: 1053886242
Provider Name (Legal Business Name): MFERRA THERAPY AND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2018
Last Update Date: 10/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1581 STATE ROUTE 23
WAYNE NJ
07470-7506
US

IV. Provider business mailing address

121 MARION DR
PLAINSBORO NJ
08536-2020
US

V. Phone/Fax

Practice location:
  • Phone: 609-240-4246
  • Fax:
Mailing address:
  • Phone: 609-240-4246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MELISSA FERRA
Title or Position: OWNER AND THERAPIST
Credential: MSW, LCSW
Phone: 609-240-4246