Provider Demographics
NPI:1982705034
Name:FERLAND, STACY L (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:L
Last Name:FERLAND
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 GEORGES RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-2955
Mailing Address - Country:US
Mailing Address - Phone:732-882-9624
Mailing Address - Fax:732-254-3085
Practice Address - Street 1:603 GEORGES RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-2955
Practice Address - Country:US
Practice Address - Phone:732-882-9624
Practice Address - Fax:732-254-3085
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052535001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH801551000OtherMAGELLAN PROV. #
NH361373OtherMHN PROVIDER #
NJP3590322OtherOXFORD PROV. #
NJ245787OtherCOMPSYCH PROV. #
NJP3590322OtherOXFORD PROV. #