Provider Demographics
NPI:1518118918
Name:FERGUSON, CASEY ELIZABETH (LPC)
Entity type:Individual
Prefix:MS
First Name:CASEY
Middle Name:ELIZABETH
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:ELIZABETH HENSHAW
Other - Last Name:FERGUSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:2795 HAYNES RD
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:VA
Mailing Address - Zip Code:24301-5068
Mailing Address - Country:US
Mailing Address - Phone:540-505-2986
Mailing Address - Fax:540-380-0079
Practice Address - Street 1:6580 VALLEY CENTER DR STE 169
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:VA
Practice Address - Zip Code:24141-5694
Practice Address - Country:US
Practice Address - Phone:540-505-2986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-02
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA07010044002101YM0800X
VA0701004402101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor