Provider Demographics
NPI:1417904426
Name:FERROVIA, JEAN M (LICSW)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:M
Last Name:FERROVIA
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-1052
Mailing Address - Country:US
Mailing Address - Phone:781-687-2511
Mailing Address - Fax:781-687-2018
Practice Address - Street 1:200 SPRINGS ROAD 518/136G
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730
Practice Address - Country:US
Practice Address - Phone:781-687-2511
Practice Address - Fax:781-687-2018
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA102858101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health