JENNA TYLER FERGUSON (NPI# 1962016204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962016204 |
| Entity Type | Individual |
| Full Name | JENNA TYLER FERGUSON |
| Practice Address |
3622 Lyckan Pkwy Ste 3002 Durham NC 27707-2572 |
| Mailing Address |
1115 Berkeley St Durham NC 27705-3507 |
| Practice Telephone | 9196026766 |
| Mailing Telephone | 7045164601 |
| Enumeration Date | 2020-09-03 |
| Last Update Date | 2020-09-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
P012896 | NC | Behavioral Health & Social Service Providers |
| Street Address |
3622 LYCKAN PKWY STE 3002 |
| City | DURHAM |
| State | NC |
| Zip Code | 27707-2572 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154794030 | Samantha Scuderi | Marriage & Family Therapist | 3622 Lyckan Pkwy Ste 3002, Durham, NC 27707-2572 | 2015-11-02 |
| 1467090886 | Blair Marini | Social Worker | 3622 Lyckan Pkwy Ste 3002, Durham, NC 27707-2572 | 2019-12-16 |
| 1073155388 | Christine Pavey | Social Worker | 3622 Lyckan Pkwy Ste 3002, Durham, NC 27707-2572 | 2019-10-09 |
| 1134689623 | Anthony Laricchiuti | Marriage & Family Therapist | 3622 Lyckan Pkwy Ste 3002, Durham, NC 27707-2572 | 2019-03-21 |
| 1962900670 | Hannah Daulton | Counselor | 3622 Lyckan Pkwy Ste 3002, Durham, NC 27707-2572 | 2018-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538785928 | Ceara Smith | Social Worker | 1415 W Nc 54 Buidling 200, Suite 111, Durham, NC 27707 | 2020-06-22 |
| 1114554094 | Lauren Michelle Grosse | Physician Assistant | Fastmed Urgent Care 7010 Nc-751, Durham, NC 27707 | 2020-03-23 |
| 1386289635 | Ashley Bailey | Counselor | 1801 Fayetteville Street, Durham, NC 27707 | 2019-11-11 |
| 1881249886 | Erin Ramona Leger | Physical Therapist | 3706 Mayfair St, Ste 120, Durham, NC 27707 | 2019-08-06 |
| 1417417262 | Carmen Elisabeth Sanchez | Psychologist | 3326 Durham Chapel Hill Blvd Bldg D, Durham, NC 27707 | 2019-03-20 |
| 1477026144 | Pope Behavioral Health and Wellness | Counselor | 5102 Chapel Hill Durham Blvd., Suite 101, Durham, NC 27707 | 2019-01-06 |
| 1043780778 | Jessica Ann Revels | Counselor | 1415 West North Carolina 54, Building 100 Suite # 204, Durham, NC 27707 | 2018-11-26 |
| 1558830125 | Michael Brown | Counselor | 1502 W Nc-54, Suite 505, Durham, NC 27707 | 2018-11-13 |
| 1780152827 | Cassandra Gerwig Shaw | Registered Nurse | 5324 Mcfarland Dr Ste 310, Durham, NC 27707 | 2018-11-07 |
| 1942776232 | Lisa J Keskitalo | Physical Therapist | 3708 Mayfair St Ste 120, Durham, NC 27707 | 2018-10-15 |
| Find all providers in zip 27707 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770184657 | Delia Hearon | Social Worker | 100 Village Circle Way Apt 216, Durham, NC 27713-6131 | 2020-11-05 |
| 1750980256 | Victoria Snow | Social Worker | 504 E Pettigrew St Apt 449, Durham, NC 27701-3888 | 2020-10-26 |
| 1053910984 | Tedra Cook | Social Worker | 313 Chestnut Oak Pl, Durham, NC 27704-5196 | 2020-10-21 |
| 1821695644 | Adam Tannenbaum | Social Worker | 1821 Hillandale Rd Ste 1b-154, Durham, NC 27705-2659 | 2020-10-05 |
| 1831706373 | Elena Plocek | Social Worker | 2617 Farthing St, Durham, NC 27704-4203 | 2020-09-29 |
| 1225643323 | Aisha S Lewis | Social Worker | 79 Willow Bridge Dr, Durham, NC 27707-5457 | 2020-09-15 |
| 1639781354 | Inner Knowing Clinical Therapy LLC | Social Worker | 117 Brown Rd, Durham, ME 04222-5213 | 2020-08-24 |
| 1730791765 | Katrina P Martin | Social Worker | 2511 N Roxboro St, Durham, NC 27704-4347 | 2020-08-20 |
| 1194337758 | Ashley Esry | Social Worker | 1728 Euclid Rd, Durham, NC 27713-2415 | 2020-08-17 |
| 1265050124 | Amber Cox | Social Worker | 3622 Lyckan Pkwy Ste 5007, Durham, NC 27707-2539 | 2020-07-08 |
| Find all providers in DURHAM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.