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General NPI Number Information
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NPI Number | 1427701549
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Entity Type | Organization
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Legal Business Name | JENSA FERGUSON, LMHC, INC.
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Dates
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Enumeration Date | 01/29/2022
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Last Update Date | 01/29/2022
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Provider Practice Location Address
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Address Line | 5470 SHILSHOLE AVE NW STE 510
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City | SEATTLE
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State | WA
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Zip | 98107-4040
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Country | US
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Telephone | 206-619-7628
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Fax |
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Provider Business Mailing Address
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Address Line | 23830 78TH AVE W
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City | EDMONDS
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State | WA
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Zip | 98026-8821
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Country | US
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Telephone | 206-473-7745
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Fax |
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Authorized Official
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Title or Position | OWNER, PRESIDENT
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Name | JENIFER L FERGUSON
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Credential | LMHC
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Telephone | 206-619-7628
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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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