Individual
MRS. CORRI J FERDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LLC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
23620
IL
1041C0700X
Clinical Social Worker
Primary
149009759
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200866811
CORPHEALTH
IL
01
—
493-2415
BLUE CROSS BLUE SHIELD
IL
01
—
793339000
MAGELLAN
IL
Enumeration date
04/09/2007
Last updated
03/02/2010
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