Provider Demographics
NPI:1235971235
Name:FERGUSON COUNSELING GROUP, PLLC
Entity type:Organization
Organization Name:FERGUSON COUNSELING GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CORINNE
Authorized Official - Middle Name:
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:773-245-3695
Mailing Address - Street 1:1531 W HOWARD ST APT 508
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-1898
Mailing Address - Country:US
Mailing Address - Phone:773-318-2716
Mailing Address - Fax:
Practice Address - Street 1:4255 N KNOX AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-1904
Practice Address - Country:US
Practice Address - Phone:773-245-3695
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-10
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty