Healthcare Provider Details

I. General information

NPI: 1548242852
Provider Name (Legal Business Name): RONALD J FERGUSON MSW LISW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 02/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3284 W NORTH BEND RD SUITE 314
CINCINNATI OH
45239-7688
US

IV. Provider business mailing address

3284 W NORTH BEND RD SUITE 314
CINCINNATI OH
45239-7688
US

V. Phone/Fax

Practice location:
  • Phone: 513-481-2432
  • Fax: 513-662-2432
Mailing address:
  • Phone: 513-481-2432
  • Fax: 513-662-2432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI0002871
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: