Basic Information
Provider Information
NPI: 1992369441
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FERRAIUOLO
FirstName: DOLLY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 140 MEADOWLARK DR
Address2:  
City: SAFETY HARBOR
State: FL
PostalCode: 346952020
CountryCode: US
TelephoneNumber: 7277553018
FaxNumber: 7273763652
Practice Location
Address1: 4800 ROWAN RD
Address2:  
City: NEW PORT RICHEY
State: FL
PostalCode: 346535609
CountryCode: US
TelephoneNumber: 7274835912
FaxNumber: 7273763652
Other Information
ProviderEnumerationDate: 04/30/2019
LastUpdateDate: 02/06/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/06/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XSW17572FLN Behavioral Health & Social Service ProvidersCounselorMental Health
101YM0800XISW12690FLN Behavioral Health & Social Service ProvidersCounselorMental Health
1041C0700XSW17572FLY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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