Provider Demographics
NPI:1174072136
Name:FERGUSON, SARA (LMSW)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 DUMONT DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-6947
Mailing Address - Country:US
Mailing Address - Phone:281-799-8760
Mailing Address - Fax:
Practice Address - Street 1:806 HEBRON PKWY
Practice Address - Street 2:1102
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-5003
Practice Address - Country:US
Practice Address - Phone:972-878-8527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-30
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX628871041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker