Provider Demographics
NPI:1861254799
Name:FERRARI, VELVET CAROLINE
Entity type:Individual
Prefix:
First Name:VELVET
Middle Name:CAROLINE
Last Name:FERRARI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BOULDER DR NW
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-1074
Mailing Address - Country:US
Mailing Address - Phone:678-315-5782
Mailing Address - Fax:
Practice Address - Street 1:7 BOULDER DR NW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-1074
Practice Address - Country:US
Practice Address - Phone:678-315-5782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC013760101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional