Provider Demographics
NPI:1508562497
Name:FERRIS, ELISA JORDAN (MSW)
Entity Type:Individual
Prefix:
First Name:ELISA
Middle Name:JORDAN
Last Name:FERRIS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 HARRIS AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-7045
Mailing Address - Country:US
Mailing Address - Phone:360-734-7310
Mailing Address - Fax:360-647-8336
Practice Address - Street 1:960 HARRIS AVE STE 206
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-7045
Practice Address - Country:US
Practice Address - Phone:360-661-1823
Practice Address - Fax:360-647-8336
Is Sole Proprietor?:No
Enumeration Date:2023-02-02
Last Update Date:2023-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC61114437101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health