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NPI Code Detail

MEDICARE: MRS. KAYLA FERRIE MSW, LICSW

MEDICARE:  MRS. KAYLA  FERRIE  MSW, LICSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor1450942OH
21041C0700XClinical Social WorkerI.1800901MN
31041C0700XClinical Social Worker27584MN

General Provider Information

NPI Number : 1093221400
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KAYLA FERRIE MSW, LICSW
Provider Business Mailing Address
First Line : 1555 NORTHWAY DR
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56303-4555
Country : US
Telephone Number : 320-251-1775
Fax Number :
Provider Business Practice Location Address
First Line : 1555 NORTHWAY DR STE 100
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56303-1258
Country : US
Telephone Number : 651-263-7062
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2017
Last Update Date : 06/27/2019

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