Healthcare Provider Details

I. General information

NPI: 1457463622
Provider Name (Legal Business Name): JANICE H FERRIS LCSW-R
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 UTICA ST SUITE 2
CLINTON NY
13323-1554
US

IV. Provider business mailing address

51 UTICA ST SUITE 2
CLINTON NY
13323-1554
US

V. Phone/Fax

Practice location:
  • Phone: 315-853-5292
  • Fax:
Mailing address:
  • Phone: 315-853-5292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberRO39547
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberLC50078214
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: