Individual provider Active NPI

Robert Ferrelle, LCSW

  • Clinical Social Worker
  • Savannah, GA
National Provider Identifier
1417484072
Registry record updated May 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW002963 Issued in GA
Practice address
785 King George Blvd Ste 101
Savannah, GA 31419-8376
Phone
(912) 349-4376
NPI assigned
May 15, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW002963 GA Primary

Addresses

Primary practice location

785 King George Blvd Ste 101
Savannah, GA 31419-8376

Mailing address

109 Chinese Fir CT
Pooler, GA 31322-4038
Phone (912) 330-9923

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW002963GAMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1494806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494806400000",
    "number": "1417484072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 CHINESE FIR CT",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224038",
            "telephone_number": "912-330-9923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 KING GEORGE BLVD STE 101",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314198376",
            "telephone_number": "912-349-4376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRELLE",
        "first_name": "ROBERT",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-15",
        "last_updated": "2017-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW002963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.