Provider Demographics
NPI:1376706382
Name:FERREIRA, MARYBETH KATHERINE (MA CAGS)
Entity Type:Individual
Prefix:MRS
First Name:MARYBETH
Middle Name:KATHERINE
Last Name:FERREIRA
Suffix:
Gender:F
Credentials:MA CAGS
Other - Prefix:MISS
Other - First Name:MARYBETH
Other - Middle Name:KATHERINE
Other - Last Name:KACZYNSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CAGS
Mailing Address - Street 1:340 MAIN ST
Mailing Address - Street 2:SUITE 383
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1604
Mailing Address - Country:US
Mailing Address - Phone:508-791-4976
Mailing Address - Fax:
Practice Address - Street 1:340 MAIN ST
Practice Address - Street 2:SUITE 383
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1604
Practice Address - Country:US
Practice Address - Phone:508-791-4976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor