Provider Demographics
NPI:1467853986
Name:FERGUSON, SALENA SHARISE (BSW)
Entity Type:Individual
Prefix:
First Name:SALENA
Middle Name:SHARISE
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1946 N. 13TH STREET
Mailing Address - Street 2:SUITE 420
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-7264
Mailing Address - Country:US
Mailing Address - Phone:419-720-9247
Mailing Address - Fax:419-725-2721
Practice Address - Street 1:1946 N. 13TH STREET
Practice Address - Street 2:SUITE 420
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-7264
Practice Address - Country:US
Practice Address - Phone:419-720-9247
Practice Address - Fax:419-725-2721
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health