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NPI Code Detail

MEDICARE: CAMIRA FERGUSON LPC

MEDICARE: CAMIRA FERGUSON LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorAPC008770GA
2101YP2500XProfessional CounselorLPC015409GA

General Provider Information

NPI Number : 1013629765
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAMIRA FERGUSON LPC
Provider Business Mailing Address
First Line : 4456 OAKLEAF CV
Second Line :
City : DECATUR
State : GA
Zip : 30034-6246
Country : US
Telephone Number : 309-750-0503
Fax Number :
Provider Business Practice Location Address
First Line : 690 COURTENAY DR NE
Second Line :
City : ATLANTA
State : GA
Zip : 30306-3421
Country : US
Telephone Number : 404-875-4551
Fax Number : 404-892-1770
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2022
Last Update Date : 02/06/2026

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Directions to “ CAMIRA FERGUSON LPC” Practice Location

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