Provider Demographics
NPI:1164754263
Name:MORTON, JANE FERGUSON (PHD, BCBA-D)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:FERGUSON
Last Name:MORTON
Suffix:
Gender:F
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:ELLEN
Other - Last Name:FERGUSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, BCBA-D
Mailing Address - Street 1:7784 INNOVATION PARK DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70820-7006
Mailing Address - Country:US
Mailing Address - Phone:225-343-4232
Mailing Address - Fax:225-343-4233
Practice Address - Street 1:7784 INNOVATION PARK DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70820-7006
Practice Address - Country:US
Practice Address - Phone:225-343-4232
Practice Address - Fax:225-343-4233
Is Sole Proprietor?:No
Enumeration Date:2010-02-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1084454103K00000X
LA1113103T00000X, 103TS0200X
LAL-011103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2340395Medicaid