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General NPI Number Information
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NPI Number | 1770913253
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Entity Type | Organization
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Legal Business Name | LORI J. FERGUSON, LCSW, LLC
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Dates
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Enumeration Date | 11/19/2013
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Last Update Date | 04/29/2016
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Provider Practice Location Address
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Address Line | 246 FEDERAL RD STE D22
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City | BROOKFIELD
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State | CT
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Zip | 06804-2650
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Country | US
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Telephone | 914-772-2481
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Fax | 914-885-1730
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Provider Business Mailing Address
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Address Line | 65 AUNT HACK RD
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City | DANBURY
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State | CT
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Zip | 06811-2720
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Country | US
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Telephone | 914-772-2481
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Fax | 914-885-1730
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Authorized Official
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Title or Position | OWNER
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Name | MS. LORI J FERGUSON
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Credential | LCSW
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Telephone | 914-772-2481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 003381
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License Number State | CT
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