Provider Demographics
NPI:1831512128
Name:BELINDA G. FERRERO
Entity type:Organization
Organization Name:BELINDA G. FERRERO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MASTER OF SOCIAL WORK
Authorized Official - Prefix:MRS
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:G
Authorized Official - Last Name:FERRERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-592-5779
Mailing Address - Street 1:1748 INDIAN RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-6857
Mailing Address - Country:US
Mailing Address - Phone:678-592-5779
Mailing Address - Fax:
Practice Address - Street 1:1748 INDIAN RIDGE DR
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-6857
Practice Address - Country:US
Practice Address - Phone:678-592-5779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW006319104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGEORGIAMedicaid