Provider Demographics
NPI:1336748268
Name:FERGUSON, MEGAN (MSW, LISW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:FERGUSON
Suffix:
Gender:F
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 1:2516 GARDENIA DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-5515
Mailing Address - Country:US
Mailing Address - Phone:740-517-0824
Mailing Address - Fax:
Practice Address - Street 1:2516 GARDENIA DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-5515
Practice Address - Country:US
Practice Address - Phone:740-517-0824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.20022151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical