Provider Demographics
NPI:1346011764
Name:FERGUSON, KIRSTEN NICOLE (LCSW)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:NICOLE
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KIRSTEN
Other - Middle Name:NICOLE
Other - Last Name:LEIF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PMB 379 558 CASTLE PINES PARKWAY
Mailing Address - Street 2:UNIT B4
Mailing Address - City:CASTLE PINES
Mailing Address - State:CO
Mailing Address - Zip Code:80108
Mailing Address - Country:US
Mailing Address - Phone:720-295-1815
Mailing Address - Fax:
Practice Address - Street 1:5777 JASPER POINTE CIR
Practice Address - Street 2:
Practice Address - City:CASTLE PINES
Practice Address - State:CO
Practice Address - Zip Code:80108-9154
Practice Address - Country:US
Practice Address - Phone:720-938-2618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099288611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical