| Christine Adaline Ferguson Lsw, Licdc Llc | |
|
16360 Broadway Ave Ste 21016360 Maple Heights OH 44137-2555 | |
| (216) 865-5050 | |
| Not Available |
| Full Name | Christine Adaline Ferguson Lsw, Licdc Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 16360 Broadway Ave Ste 21016360, Maple Heights, Ohio |
| Authorized Official Name and Position | Christine A Ferguson (OWNER/PROVIDER) |
| Authorized Official Contact | 2168655050 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Christine Adaline Ferguson Lsw, Licdc Llc 16360 Broadway Ave Ste 21016360 Maple Heights OH 44137-2555 Ph: (216) 865-5050 | Christine Adaline Ferguson Lsw, Licdc Llc 16360 Broadway Ave Ste 21016360 Maple Heights OH 44137-2555 Ph: (216) 865-5050 |
| NPI Number | 1326674052 |
|---|---|
| Provider Enumeration Date | 03/13/2020 |
| Last Update Date | 11/23/2022 |
| Certification Date | 11/23/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326674052 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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