Provider Demographics
NPI:1568895670
Name:FERGUSON, CHRISTIANN ALAINA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:CHRISTIANN
Middle Name:ALAINA
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CHRISTIANN
Other - Middle Name:
Other - Last Name:BELTRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13 EVAN CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-3347
Mailing Address - Country:US
Mailing Address - Phone:347-937-3264
Mailing Address - Fax:
Practice Address - Street 1:13 EVAN CT
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-3347
Practice Address - Country:US
Practice Address - Phone:347-937-3264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-12
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
NY120395104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker