Provider Demographics
NPI:1609074228
Name:FERGUSON, AMBER DAWN (MA, LMHP)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:DAWN
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:MA, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37801 US HIGHWAY 77
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68318-8426
Mailing Address - Country:US
Mailing Address - Phone:402-239-1798
Mailing Address - Fax:
Practice Address - Street 1:1123 N. 9TH ST.
Practice Address - Street 2:
Practice Address - City:BEATRICE
Practice Address - State:NE
Practice Address - Zip Code:68310
Practice Address - Country:US
Practice Address - Phone:402-228-3386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2010-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8322101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE82327OtherBLUE CROSS BLUE SHIELD