Healthcare Provider Details

I. General information

NPI: 1396554267
Provider Name (Legal Business Name): DANIEL JOSEPH FERRER LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2025
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6525 GREEN BAY RD STE 2
KENOSHA WI
53142-2967
US

IV. Provider business mailing address

6525 GREEN BAY RD STE 2
KENOSHA WI
53142-2967
US

V. Phone/Fax

Practice location:
  • Phone: 262-539-7800
  • Fax:
Mailing address:
  • Phone: 262-999-3495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11266125
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11266-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: