Provider Demographics
NPI:1700969185
Name:FERRELL AND ASSOCIATES, INC.
Entity Type:Organization
Organization Name:FERRELL AND ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:LP, CAC, SAP
Authorized Official - Phone:570-826-0999
Mailing Address - Street 1:131 LAIRD ST
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18705-3818
Mailing Address - Country:US
Mailing Address - Phone:570-826-0999
Mailing Address - Fax:570-208-0603
Practice Address - Street 1:111 N FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18701-1401
Practice Address - Country:US
Practice Address - Phone:570-826-0999
Practice Address - Fax:570-208-0603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-22
Last Update Date:2010-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS003591L103TC0700X
PASW005118E104100000X
PACW001159L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty