Provider Demographics
NPI:1659615896
Name:FERGUSON, SHARONDA NISHA (LCMHC,BCBA,LBA)
Entity type:Individual
Prefix:MS
First Name:SHARONDA
Middle Name:NISHA
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:LCMHC,BCBA,LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6985 NEXUS CT STE 107
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3186
Mailing Address - Country:US
Mailing Address - Phone:910-493-3999
Mailing Address - Fax:910-728-4644
Practice Address - Street 1:351 WAGONER DRIVE
Practice Address - Street 2:SUITE 350
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303
Practice Address - Country:US
Practice Address - Phone:910-493-3999
Practice Address - Fax:910-728-4644
Is Sole Proprietor?:No
Enumeration Date:2012-11-10
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10297101Y00000X
NC1-12-12589103K00000X
NC958103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101Y00000XBehavioral Health & Social Service ProvidersCounselor