Provider Demographics
NPI:1770978322
Name:MCFERRAN, JESSICA (LISW-S)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:MCFERRAN
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:JESSE
Other - Middle Name:
Other - Last Name:MCFERRAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LISW-S
Mailing Address - Street 1:3333 BURNET AVE
Mailing Address - Street 2:MLC 6019
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-4124
Mailing Address - Fax:513-636-4283
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:MLC 6019
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-4124
Practice Address - Fax:513-636-4283
Is Sole Proprietor?:No
Enumeration Date:2015-03-31
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.0900317-SUPV104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker