Provider Demographics
NPI:1598341901
Name:FERRELL, GILES JUNUIS II (MHC-LP)
Entity Type:Individual
Prefix:MR
First Name:GILES
Middle Name:JUNUIS
Last Name:FERRELL
Suffix:II
Gender:M
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 JORALEMON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-3743
Mailing Address - Country:US
Mailing Address - Phone:347-799-1877
Mailing Address - Fax:
Practice Address - Street 1:210 JORALEMON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3743
Practice Address - Country:US
Practice Address - Phone:347-799-1877
Practice Address - Fax:347-529-4652
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP108891101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health