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Individual

CASEY A FERGUSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, LMHP, CPC

Contact information

Practice address
500 WILLOW AVE, SUITE 305, COUNCIL BLUFFS, IA 51503-0827
(712) 256-4420
(712) 256-4423
Mailing address
500 WILLOW AVE, SUITE 305, COUNCIL BLUFFS, IA 51503-0827
(712) 256-4420
(712) 256-4423

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3360
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100253517-00
NE
05
1010744
IA
Enumeration date
06/19/2008
Last updated
06/19/2008
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