Individual
DR. CARISSA Y. FERGUSON-THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, MS, PSY.D.
Contact information
Practice address
110 MARTER AVE, SUITE 201, MOORESTOWN, NJ 08057-3124
(856) 778-4330
(856) 778-4408
Mailing address
110 MARTER AVE, SUITE 201, MOORESTOWN, NJ 08057-3124
(856) 778-4330
(856) 778-4408
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
5528
NJ
1041C0700X
Clinical Social Worker
CW014630
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215470174
—
NJ
Enumeration date
12/13/2006
Last updated
02/03/2017
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