Provider Demographics
NPI:1447712690
Name:FERRARO, ELISABETH M (LCPC)
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:M
Last Name:FERRARO
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:M
Other - Last Name:FERRARO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCPC
Mailing Address - Street 1:10 N JEFFERSON ST STE 202
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4865
Mailing Address - Country:US
Mailing Address - Phone:240-750-6467
Mailing Address - Fax:
Practice Address - Street 1:10 N JEFFERSON ST STE 202
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4865
Practice Address - Country:US
Practice Address - Phone:240-750-6467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC10323101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDLC10323OtherMARYLAND BOARD OF PROFESSIONAL COUNSELORS & THERAPISTS