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General NPI Number Information
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NPI Number | 1174663546
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Entity Type | Individual
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Provider Name | DIANE JEAN FERRIS LCSW-R
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Gender | Female
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 06/15/2010
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Provider Practice Location Address
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Address Line | DIANE J. FERRIS, LCSW-R 1989 ROUTE 52, SUITE 6
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City | HOPEWELL JUNCTION
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State | NY
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Zip | 12533
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Country | US
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Telephone | 845-797-2228
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Fax |
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Provider Business Mailing Address
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Address Line | 1989 ROUTE 52 SUITE 6
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City | HOPEWELL JCT
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State | NY
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Zip | 12533-3533
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Country | US
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Telephone | 845-797-2228
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 060670-1
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License Number State | NY
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