Provider Demographics
NPI:1154641553
Name:FERRARO, GINA MARIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:GINA
Middle Name:MARIE
Last Name:FERRARO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 RIDGEFIELD RD
Mailing Address - Street 2:
Mailing Address - City:ENDICOTT
Mailing Address - State:NY
Mailing Address - Zip Code:13760-4256
Mailing Address - Country:US
Mailing Address - Phone:607-757-2152
Mailing Address - Fax:607-757-2864
Practice Address - Street 1:263 RIDGEFIELD RD
Practice Address - Street 2:
Practice Address - City:ENDICOTT
Practice Address - State:NY
Practice Address - Zip Code:13760-4256
Practice Address - Country:US
Practice Address - Phone:607-757-2152
Practice Address - Fax:607-757-2864
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-08
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY074714104100000X
NY6435200511041S0200X
NY0803281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool