Provider Demographics
NPI:1003013772
Name:FOUGERE, AGUSTINA (MA)
Entity Type:Individual
Prefix:MRS
First Name:AGUSTINA
Middle Name:
Last Name:FOUGERE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 MANHATTAN AVE APT 3L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-3930
Mailing Address - Country:US
Mailing Address - Phone:718-349-3155
Mailing Address - Fax:
Practice Address - Street 1:300 FLATBUSH AVE
Practice Address - Street 2:BROOKLYN CENTER FOR PSYCHOTHERAPY
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-2812
Practice Address - Country:US
Practice Address - Phone:718-622-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health