Provider Demographics
NPI:1275757494
Name:FERGUSON, ALISON D (LCSW)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:D
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 MILITARY CUTOFF RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-5730
Mailing Address - Country:US
Mailing Address - Phone:910-616-9706
Mailing Address - Fax:910-679-4563
Practice Address - Street 1:1508 MILITARY CUTOFF RD
Practice Address - Street 2:SUITE 205
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-5730
Practice Address - Country:US
Practice Address - Phone:910-616-9706
Practice Address - Fax:910-679-4563
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0035001041C0700X
NCC0056071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical