Provider Demographics
NPI:1003398454
Name:FERIOZZI, LAWRENCE ANTON (MS, CCTP)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:ANTON
Last Name:FERIOZZI
Suffix:
Gender:M
Credentials:MS, CCTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 BARTOW ST.
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34982
Mailing Address - Country:US
Mailing Address - Phone:850-543-1443
Mailing Address - Fax:
Practice Address - Street 1:15818 SW WARFIELD BLVD,
Practice Address - Street 2:
Practice Address - City:INDIANTOWN
Practice Address - State:FL
Practice Address - Zip Code:34956
Practice Address - Country:US
Practice Address - Phone:772-597-0411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-02
Last Update Date:2018-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health