Provider Demographics
NPI:1790226009
Name:FERDA, ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:FERDA
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 1:1826 SNAKE RIVER RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-7750
Mailing Address - Country:US
Mailing Address - Phone:281-394-1379
Mailing Address - Fax:
Practice Address - Street 1:1826 SNAKE RIVER RD
Practice Address - Street 2:SUITE D
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-7750
Practice Address - Country:US
Practice Address - Phone:281-394-1379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63727101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health