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NPI Code Detail

MEDICARE: MS. ANDRA L FERGUSON MS, LPC

MEDICARE: MS. ANDRA L FERGUSON MS, 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
1101Y00000XCounselor2002022766MO

General Provider Information

NPI Number : 1770573545
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANDRA L FERGUSON MS, LPC
Provider Business Mailing Address
First Line : 100 S LIMIT AVE
Second Line :
City : SEDALIA
State : MO
Zip : 65301-3655
Country : US
Telephone Number : 660-826-7909
Fax Number : 660-826-6737
Provider Business Practice Location Address
First Line : 100 S LIMIT AVE
Second Line :
City : SEDALIA
State : MO
Zip : 65301-3655
Country : US
Telephone Number : 660-826-7909
Fax Number : 660-826-6737
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2005
Last Update Date : 07/08/2007

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