Provider Demographics
NPI:1679399786
Name:FERRETTI, JESSICA ANN (LSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANN
Last Name:FERRETTI
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 MOOSIC ST
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18505-4550
Mailing Address - Country:US
Mailing Address - Phone:570-351-7373
Mailing Address - Fax:
Practice Address - Street 1:1160 SAND ST
Practice Address - Street 2:
Practice Address - City:JESSUP
Practice Address - State:PA
Practice Address - Zip Code:18434-1731
Practice Address - Country:US
Practice Address - Phone:570-906-5633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1323321041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool