Provider Demographics
NPI:1972638930
Name:FERRIS, GRETCHEN (MS, LPC,LMFT)
Entity Type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:
Last Name:FERRIS
Suffix:
Gender:F
Credentials:MS, LPC,LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12890 HILLCREST RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-1504
Mailing Address - Country:US
Mailing Address - Phone:972-239-6312
Mailing Address - Fax:972-702-9428
Practice Address - Street 1:12890 HILLCREST RD
Practice Address - Street 2:SUITE 200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1504
Practice Address - Country:US
Practice Address - Phone:972-239-6312
Practice Address - Fax:972-702-9428
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8816101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health