Provider Demographics
NPI:1912045741
Name:FERRARA, RITA A (MSW LCSW)
Entity Type:Individual
Prefix:MRS
First Name:RITA
Middle Name:A
Last Name:FERRARA
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:MS
Other - First Name:RITA
Other - Middle Name:A
Other - Last Name:FERRARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW LCSW
Mailing Address - Street 1:135 HEATHERINGTON COURT
Mailing Address - Street 2:
Mailing Address - City:LANOKA HARBOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08734
Mailing Address - Country:US
Mailing Address - Phone:609-971-1274
Mailing Address - Fax:609-971-8242
Practice Address - Street 1:620 LACEY ROAD
Practice Address - Street 2:SUITE 5
Practice Address - City:FORKED RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08731
Practice Address - Country:US
Practice Address - Phone:609-693-5000
Practice Address - Fax:609-971-8242
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC004405001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ896976Medicare ID - Type Unspecified