Provider Demographics
NPI:1447993753
Name:FERREIRA, ADELAINE KELLER (CSW)
Entity type:Individual
Prefix:
First Name:ADELAINE
Middle Name:KELLER
Last Name:FERREIRA
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 BANBURY DR
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:UT
Mailing Address - Zip Code:84075-9534
Mailing Address - Country:US
Mailing Address - Phone:801-645-0281
Mailing Address - Fax:
Practice Address - Street 1:1379 N 1075 W STE 228
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:UT
Practice Address - Zip Code:84025-2859
Practice Address - Country:US
Practice Address - Phone:385-316-7127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-14
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical