Provider Demographics
NPI:1942226295
Name:FERGUSON, ROSA H
Entity Type:Individual
Prefix:MS
First Name:ROSA
Middle Name:H
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ROSE
Other - Middle Name:
Other - Last Name:FERGUSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 6744
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70174-6744
Mailing Address - Country:US
Mailing Address - Phone:504-309-7844
Mailing Address - Fax:504-309-7845
Practice Address - Street 1:3925 N I 10 SERVICE RD W
Practice Address - Street 2:SUITE 109 N
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-6867
Practice Address - Country:US
Practice Address - Phone:504-302-0680
Practice Address - Fax:504-309-7845
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA39441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical