Fern Lane Counseling LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

FERN LANE COUNSELING LLC

Practice address

10424 Tiffany Village CT
Saint Louis, MO 63123-8001

Phone

(217) 929-8651

Fax

(314) 828-1232

NPI assigned

Jun 9, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Matthew Swango, LCSWNPI 1831752740

Title

Owner

Phone

(217) 929-8651

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew Eric Swango, LCSW

  • Clinical Social Worker
  • Saint Louis, MO
  • NPI 1831752740
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663113600000",
    "number": "1093444523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10424 TIFFANY VILLAGE CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631238001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10424 TIFFANY VILLAGE CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631238001",
            "telephone_number": "217-929-8651",
            "fax_number": "314-828-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERN LANE COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-09",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A",
        "authorized_official_last_name": "SWANGO",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-929-8651",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Timothy Ferguson, M.D.
• Rashida Ferguson
• Warren Ferguson, LPC
• William S Ferguson, MD
• Alma Ferhatbegovic, PT
• Anna Cristina Fernandez, M.D.
• Daisy Fernandez, MD, MPH
• Daniel Patrick Fernandez, MD
• Elizabeth A. Fernandez, AUD
• Felix Gabriel Fernandez, M.D.

• Community/Behavioral Health Agency in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Community/Behavioral Health Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.