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General NPI Number Information
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NPI Number | 1174072136
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Entity Type | Individual
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Provider Name | SARA FERGUSON LMSW
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Gender | Female
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Dates
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Enumeration Date | 09/30/2016
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 806 HEBRON PKWY 1102
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City | LEWISVILLE
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State | TX
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Zip | 75057-5003
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Country | US
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Telephone | 972-878-8527
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Fax |
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Provider Business Mailing Address
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Address Line | 902 DUMONT DR
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City | RICHARDSON
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State | TX
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Zip | 75080-6947
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Country | US
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Telephone | 281-799-8760
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 62887
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 62887
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License Number State | TX
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