Provider Demographics
NPI:1558564906
Name:FERRANTE, ALFRED PAUL (EDD)
Entity Type:Individual
Prefix:
First Name:ALFRED
Middle Name:PAUL
Last Name:FERRANTE
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4094 MAIN ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-3434
Mailing Address - Country:US
Mailing Address - Phone:614-777-8866
Mailing Address - Fax:614-876-0409
Practice Address - Street 1:4094 MAIN ST
Practice Address - Street 2:SUITE 204
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-3434
Practice Address - Country:US
Practice Address - Phone:614-777-8866
Practice Address - Fax:614-876-0409
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4457103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0215681Medicaid
OHFECP18331Medicare ID - Type Unspecified