Provider Demographics
NPI:1518937879
Name:FERRI, JANE M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:M
Last Name:FERRI
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:PO BOX 471
Mailing Address - Street 2:
Mailing Address - City:PUTNAM
Mailing Address - State:CT
Mailing Address - Zip Code:06260-0471
Mailing Address - Country:US
Mailing Address - Phone:860-928-5904
Mailing Address - Fax:860-928-0701
Practice Address - Street 1:5 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:PUTNAM
Practice Address - State:CT
Practice Address - Zip Code:06260-2127
Practice Address - Country:US
Practice Address - Phone:860-928-5904
Practice Address - Fax:860-928-0701
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0003731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT187552OtherMANAGER HEALTH NETWORK
CT133558OtherVALUE OPTIONS
CT14000373CT01OtherBLUE CROSS
800001430Medicare ID - Type Unspecified