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General NPI Number Information
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NPI Number | 1033717087
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Entity Type | Individual
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Provider Name | JORDAN FERRIS
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Gender | Male
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Dates
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Enumeration Date | 10/13/2020
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Last Update Date | 06/24/2024
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Provider Practice Location Address
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Address Line | 59 INTERSTATE DR STE 3
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City | WEST SPRINGFIELD
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State | MA
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Zip | 01089-5100
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Country | US
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Telephone | 774-206-1125
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 791
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City | HOLYOKE
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State | MA
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Zip | 01041-0791
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Country | US
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Telephone | 413-540-1100
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 230328
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License Number State | MA
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