Provider Demographics
NPI:1811516420
Name:FERRER, JOSE (CASAC)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:FERRER
Suffix:
Gender:M
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 PARSONS BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-2205
Mailing Address - Country:US
Mailing Address - Phone:718-670-5078
Mailing Address - Fax:718-670-8847
Practice Address - Street 1:4500 PARSONS BLVD STE 205
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-2205
Practice Address - Country:US
Practice Address - Phone:718-670-5078
Practice Address - Fax:718-670-8847
Is Sole Proprietor?:No
Enumeration Date:2020-04-14
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY18168101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)