Individual
MS. CHRISTINE E FERGUSON-MIZELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NJ LCSW
Contact information
Practice address
58 BROAD ST, MANASQUAN, NJ 08736-2907
(732) 528-9904
(732) 833-1481
Mailing address
COUNSELING ASSOCIATES CENTRAL, 58 BROAD STREET, MANASQUAN, NJ 08736
(732) 528-9904
(732) 833-1481
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SC47205
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
135449
VALUE OPTIONS PROVIDER ID
NJ
01
—
203371000
MAGELLAN PROVIDER ID
NJ
01
—
244653
MHN PROVIDER ID
NJ
01
—
N12Z9
EMPIRE BCBS PROVIDER ID
NY
Enumeration date
01/16/2007
Last updated
09/21/2012
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