Provider Demographics
NPI:1639060114
Name:NICOLE FERRISS, LLC
Entity type:Organization
Organization Name:NICOLE FERRISS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRISS
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:515-402-5434
Mailing Address - Street 1:4111 SW ELM CT
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-8237
Mailing Address - Country:US
Mailing Address - Phone:515-402-5434
Mailing Address - Fax:515-402-5434
Practice Address - Street 1:1680 SW ANKENY RD STE 1A
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-8270
Practice Address - Country:US
Practice Address - Phone:515-402-5434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NICOLE FERRISS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-07-11
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty