Provider Demographics
NPI:1548242852
Name:FERGUSON, RONALD J (MSW LISW)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:J
Last Name:FERGUSON
Suffix:
Gender:M
Credentials:MSW LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3284 W NORTH BEND RD
Mailing Address - Street 2:SUITE 314
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-7688
Mailing Address - Country:US
Mailing Address - Phone:513-481-2432
Mailing Address - Fax:513-662-2432
Practice Address - Street 1:3284 W NORTH BEND RD
Practice Address - Street 2:SUITE 314
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-7688
Practice Address - Country:US
Practice Address - Phone:513-481-2432
Practice Address - Fax:513-662-2432
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00028711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2272231Medicaid
OH2272231Medicaid
S08569Medicare UPIN