Individual
MS. CHRISTINE A FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICDC-LISW
Contact information
Practice address
16360 BROADWAY AVE STE B101, MAPLE HEIGHTS, OH 44137-2573
(216) 510-7170
(216) 510-7213
Mailing address
18320 MAPLEBORO AVE, MAPLE HEIGHTS, OH 44137-2768
(216) 727-6410
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.161363
OH
104100000X
Social Worker
S 1201586
OH
1041C0700X
Clinical Social Worker
Primary
I.2102896
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0488448
—
OH
Enumeration date
01/12/2017
Last updated
11/23/2022
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