Individual
MICHEAL JAVON FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCAS-P, LCSW-P
Contact information
Practice address
8430 UNIVERSITY EXECUTIVE PARK DR., 655, CHARLOTTE, NC 28262
(704) 596-5553
(704) 596-1556
Mailing address
8430 UNIVERSITY EXECUTIVE PARK DR., 655, CHARLOTTE, NC 28262
(704) 596-5553
(704) 596-1556
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
P006435
NC
Other
Enumeration date
07/18/2011
Last updated
07/18/2011
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