Provider Demographics
NPI:1568891646
Name:FERGUSON, LOIS (LPC)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 420
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-0420
Mailing Address - Country:US
Mailing Address - Phone:973-534-9807
Mailing Address - Fax:973-786-5029
Practice Address - Street 1:10 POPLAR TREE LN
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-2317
Practice Address - Country:US
Practice Address - Phone:973-534-9807
Practice Address - Fax:973-786-5029
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-08
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00485900101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional