Provider Demographics
NPI:1396889796
Name:FERRERA, JAMES M (MS)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:M
Last Name:FERRERA
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 BOTTUMS RD
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01062-2619
Mailing Address - Country:US
Mailing Address - Phone:413-586-1058
Mailing Address - Fax:
Practice Address - Street 1:1111 ELM ST
Practice Address - Street 2:#30
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-1540
Practice Address - Country:US
Practice Address - Phone:413-739-7585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA378106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALM1188OtherBLUE CROSS BLUE SHIELD
MA117108Medicare UPIN
MA410000378MA01Medicare UPIN