MEDICARE: ROSCOE FERRIS

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
1	1041C0700X	Clinical Social Worker	089.0071646	VT

General Provider Information

NPI Number	:	1568763118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSCOE FERRIS

Provider Business Mailing Address
First Line	:	57 STARBIRD RD
Second Line	:
City	:	JERICHO
State	:	VT
Zip	:	05465-2525
Country	:	US
Telephone Number	:	802-310-7248
Fax Number	:

Provider Business Practice Location Address
First Line	:	8 PEARL ST
Second Line	:
City	:	ESSEX JUNCTION
State	:	VT
Zip	:	05452-3604
Country	:	US
Telephone Number	:	802-310-7248
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2010
Last Update Date	:	12/05/2022

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Directions to “ ROSCOE FERRIS ” Practice Location

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