Lisa Ferretti Lisw Llc | |
1221 Park Pl Ne Ste F Cedar Rapids IA 52402-2019 | |
(319) 440-0751 | |
(319) 409-8071 |
Full Name | Lisa Ferretti Lisw Llc |
---|---|
Speciality | Counselor |
Location | 1221 Park Pl Ne Ste F, Cedar Rapids, Iowa |
Authorized Official Name and Position | Lisa Ferretti (OWNER) |
Authorized Official Contact | 3194400751 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Lisa Ferretti Lisw Llc 1221 Park Pl Ne Ste F Cedar Rapids IA 52402-2019 Ph: (319) 440-0751 | Lisa Ferretti Lisw Llc 1221 Park Pl Ne Ste F Cedar Rapids IA 52402-2019 Ph: (319) 440-0751 |
NPI Number | 1700348265 |
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Provider Enumeration Date | 04/03/2019 |
Last Update Date | 07/12/2022 |
Certification Date | 07/12/2022 |
Medicare PECOS PAC ID | 2062754062 |
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Medicare Enrollment ID | O20190423000984 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700348265 | NPI | - | NPPES |
104339000 | Medicaid | IA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Provider Name | Lisa Ferretti |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1912398835 PECOS PAC ID: 2163708231 Enrollment ID: I20170405000247 |
Provider Name | Tracy Adam |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1154962991 PECOS PAC ID: 9133501778 Enrollment ID: I20220729000659 |
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