Individual
MS. LEIGH FAGERSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LCADC
Contact information
Practice address
104 BAYARD ST, NEW BRUNSWICK, NJ 08901-2389
(732) 847-2869
Mailing address
4 AUER CT STE G, EAST BRUNSWICK, NJ 08816-5826
(732) 672-8754
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
10/17/2022
Last updated
04/23/2024
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