Provider Demographics
NPI:1962265322
Name:FERRAL, ALONZO JOEL (MSW)
Entity type:Individual
Prefix:
First Name:ALONZO
Middle Name:JOEL
Last Name:FERRAL
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 S WALNUT ST STE C6
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-2617
Mailing Address - Country:US
Mailing Address - Phone:575-527-5770
Mailing Address - Fax:575-532-1928
Practice Address - Street 1:151 S WALNUT ST STE C6
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-2617
Practice Address - Country:US
Practice Address - Phone:575-527-5770
Practice Address - Fax:575-532-1928
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM11780104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty