Healthcare Provider Details
I. General information
NPI: 1104198571
Provider Name (Legal Business Name): CASEY L FERBER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/01/2012
Last Update Date: 01/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
94-98 MANHATTAN AVENUE
BROOKLYN NY
11206-2505
US
IV. Provider business mailing address
60 MADISON AVE 5TH FLOOR
NEW YORK NY
10010-1600
US
V. Phone/Fax
- Phone: 718-388-0390
- Fax: 718-486-5741
- Phone: 212-545-2439
- Fax: 646-312-0481
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 082795-1 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 084221-1 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: