| Doctor Name: | MS. STACEY A FERISE |
| NPI Number: | 1205182227 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LAC, NCC, DRCC |
| License Number: | 37AC00127200 |
| Business Practice Address: | 705 Summerfield Ave Asbury Park, NJ - 077126921 |
| Business Phone Number: | 7327746886 |
| Business Fax Number: | 7327748809 |
| Mailing Address: | 705 Summerfield Ave, ASBURY PARK |
| State: | NJ |
| Postal Code: | 077126921 |
| Phone Number: | 7327746886 |
| Fax Number: | 7327748809 |
| NPI Enumeration Date: | 07/27/2012 |
| NPI Last Update Date: | 07/27/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 37AC00127200 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |