Healthcare Provider Details
I. General information
NPI: 1225366180
Provider Name (Legal Business Name): NANCY ANNETTE FERRELL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/03/2009
Last Update Date: 03/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
429 N WATER ST
SILVERTON OR
97381-1645
US
IV. Provider business mailing address
5770 VALLEY VIEW RD NE
SILVERTON OR
97381-9765
US
V. Phone/Fax
- Phone: 971-218-2000
- Fax:
- Phone: 503-873-3137
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 1948 |
| License Number State | OR |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: