Provider Demographics
NPI:1679638951
Name:FERGUSON, ROBERT (PHD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:FERGUSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 MILL ROCK CT
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-4109
Mailing Address - Country:US
Mailing Address - Phone:919-918-7635
Mailing Address - Fax:919-286-7033
Practice Address - Street 1:2020 W MAIN ST
Practice Address - Street 2:SUITE #301
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4683
Practice Address - Country:US
Practice Address - Phone:919-286-3453
Practice Address - Fax:919-286-7033
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2539103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling