Provider Demographics
NPI:1679538276
Name:FERRARA, KRISTIE (LPC)
Entity Type:Individual
Prefix:MS
First Name:KRISTIE
Middle Name:
Last Name:FERRARA
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 1:35 BEAVERSON BLVD
Mailing Address - Street 2:BUILDING 6 SUITE A
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-7812
Mailing Address - Country:US
Mailing Address - Phone:732-477-7877
Mailing Address - Fax:732-477-7878
Practice Address - Street 1:35 BEAVERSON BLVD
Practice Address - Street 2:BUILDING 6 SUITE A
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-7812
Practice Address - Country:US
Practice Address - Phone:732-477-7877
Practice Address - Fax:732-477-7878
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00321200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional