Provider Demographics
NPI:1518118918
Name:FERGUSON, CASEY ELIZABETH HENSHAW (LPC)
Entity Type:Individual
Prefix:MS
First Name:CASEY
Middle Name:ELIZABETH HENSHAW
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:ELIZABETH HENSHAW
Other - Last Name:FERGUSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:600 E MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:RADFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24141-1826
Mailing Address - Country:US
Mailing Address - Phone:540-731-0838
Mailing Address - Fax:540-731-3375
Practice Address - Street 1:600 E MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:RADFORD
Practice Address - State:VA
Practice Address - Zip Code:24141-1826
Practice Address - Country:US
Practice Address - Phone:540-731-0838
Practice Address - Fax:540-731-3375
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004402101Y00000X, 101YP2500X
VA07010044002101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health