Provider Demographics
NPI:1518299510
Name:FERGUSON, LORI R (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:R
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10333 N ORACLE RD APT 15201
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85737-5136
Mailing Address - Country:US
Mailing Address - Phone:520-443-0653
Mailing Address - Fax:
Practice Address - Street 1:10333 N ORACLE RD APT 15201
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85737-5136
Practice Address - Country:US
Practice Address - Phone:520-443-0653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW 122921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical