Provider Demographics
NPI:1184705949
Name:FERGUSON, SUSAN 'DEDE' (LPC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:'DEDE'
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 TYNEBROOK LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-7429
Mailing Address - Country:US
Mailing Address - Phone:713-828-6886
Mailing Address - Fax:
Practice Address - Street 1:327 TYNEBROOK LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-7429
Practice Address - Country:US
Practice Address - Phone:713-828-6886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12434101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional