Provider Demographics
NPI:1760932735
Name:FERRUOLO, DAVID (LICSW, MLADC, EDD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:FERRUOLO
Suffix:
Gender:M
Credentials:LICSW, MLADC, EDD
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 6421
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03247-6421
Mailing Address - Country:US
Mailing Address - Phone:603-556-4360
Mailing Address - Fax:
Practice Address - Street 1:35 ACADEMY ST
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-3606
Practice Address - Country:US
Practice Address - Phone:603-556-4360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-13
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0556101YA0400X
MN278531041S0200X
NH19621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool