Provider Demographics
NPI:1659332716
Name:FERGUSON, CINDY SUE (LCSW)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:SUE
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1565
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91944-1565
Mailing Address - Country:US
Mailing Address - Phone:619-980-4797
Mailing Address - Fax:619-980-4797
Practice Address - Street 1:7851 MISSION CENTER CT STE 110
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1326
Practice Address - Country:US
Practice Address - Phone:619-980-4797
Practice Address - Fax:619-980-4797
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2025-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS202251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SW20225Medicare ID - Type Unspecified