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General NPI Number Information
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NPI Number | 1093622367
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Entity Type | Organization
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Legal Business Name | JUDI FERGUS
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Dates
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Enumeration Date | 08/25/2026
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Last Update Date | 08/25/2026
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Provider Practice Location Address
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Address Line | 2473 CARE DR STE 101
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City | TALLAHASSEE
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State | FL
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Zip | 32308-9815
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Country | US
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Telephone | 850-988-5009
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Fax | 912-230-9514
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Provider Business Mailing Address
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Address Line | 1253 WILLIAMS LANDING RD
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City | TALLAHASSEE
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State | FL
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Zip | 32310-8282
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Country | US
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Telephone | 912-230-9514
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Fax | 912-230-9514
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Authorized Official
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Title or Position | LMHC
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Name | JUDI E FERGUS
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Credential | FERGUS
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Telephone | 912-230-9514
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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