Provider Demographics
NPI:1215072426
Name:FERRARI, PAUL F (LCSW)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:F
Last Name:FERRARI
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-3315
Mailing Address - Country:US
Mailing Address - Phone:518-563-8000
Mailing Address - Fax:518-563-9001
Practice Address - Street 1:63 BROAD ST
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-3315
Practice Address - Country:US
Practice Address - Phone:518-563-8000
Practice Address - Fax:518-563-9001
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0450081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRB0248Medicare ID - Type UnspecifiedMEDICARE