Ferguson-Thomas, Carissa Y.

Ferguson-Thomas, Carissa Y. is an individual health care provider with primary practice located at 110 Marter Ave Suite 201, Moorestown NJ 08057-3124. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Ferguson-Thomas, Carissa Y. can be contacted via phone (856) 778-4330.

Contact Information

Primary practice address
110 Marter Ave Suite 201 Moorestown NJ 08057-3124
Phone: (856) 778-4330
Fax: (856) 778-4408
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X CW014630 Pennsylvania
Behavioral Health & Social Service Providers / Clinical 103TC0700X 5528 New Jersey

Profile Details

NPI number 1669533444
LBN Legal business name Ferguson-Thomas, Carissa Y.
Credentials MSW, MS, PSY.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2006
Last updated Feb 3rd, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669533444 NPPES
New Jersey MEDICAID 1215470174

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