Ferguson, Christine A

Ferguson, Christine A is an sole proprietor health care provider with primary practice located at 16360 Broadway Ave Ste B101 , Maple Heights OH 44137-2573. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Ferguson, Christine A can be contacted via phone (216) 510-7170.

Contact Information

Primary practice address
16360 Broadway Ave Ste B101 Maple Heights OH 44137-2573
Phone: (216) 510-7170
Fax: (216) 510-7213
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LICDC.161363 Ohio
Behavioral Health & Social Service Providers / Social Worker 104100000X S 1201586 Ohio
Behavioral Health & Social Service Providers / Clinical 1041C0700X I.2102896 Ohio

Profile Details

NPI number 1831635002
LBN Legal business name Ferguson, Christine A
Credentials LICDC-LISW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 12th, 2017
Last updated Nov 23rd, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831635002 NPPES
Ohio MEDICAID 0488448

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