Individual
CHARLES FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
250 W 57TH ST, NEW YORK, NY 10107-0001
(212) 582-1566
Mailing address
307 W 106TH ST APT 5FW, NEW YORK, NY 10025-0122
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
PRO39879-1
NY
Other
Enumeration date
05/12/2014
Last updated
05/12/2014
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