Provider Demographics
NPI:1902857519
Name:FERREN, REBECCA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:
Last Name:FERREN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:NEWCOMB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:3560 CARDINAL POINT DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-9235
Mailing Address - Country:US
Mailing Address - Phone:904-737-7242
Mailing Address - Fax:904-737-7254
Practice Address - Street 1:3560 CARDINAL POINT DR
Practice Address - Street 2:SUITE 204
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-9235
Practice Address - Country:US
Practice Address - Phone:904-737-7242
Practice Address - Fax:904-737-7254
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW82301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical