Individual
CARISSA FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LGSW
Contact information
Practice address
226 S JEFFERSON ST, FREDERICK, MD 21701-6205
(301) 663-6135
Mailing address
226 S JEFFERSON ST, FREDERICK, MD 21701-6205
(301) 663-6135
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
23193
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23193
MD BOARD OF SOCIAL WORK EXAMINERS
MD
Enumeration date
08/21/2017
Last updated
07/21/2022
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