Fern Haven Center

Primary specialty

CounselorTaxonomy code 101Y00000X

License

RC00046950 Issued in WA

Legal business name

FERN HAVEN CENTER

Practice address

5721 Libby Rd NE
Olympia, WA 98506-1929

Phone

(360) 754-1600

Fax

(360) 754-4452

NPI assigned

Mar 22, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rod Davis, PH.D.

Title

Director

Phone

(360) 754-1600

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114044690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5721 LIBBY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985061929",
            "telephone_number": "360-754-1600",
            "fax_number": "360-754-4452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5721 LIBBY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985061929",
            "telephone_number": "360-754-1600",
            "fax_number": "360-754-4452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERN HAVEN CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "ROD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "360-754-1600",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "WA",
            "license": "RC00046950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Anne Ferguson, DPT
• Jill Ferguson, LP00030754
• Jody Lee Ferguson, LMHC
• Kyle Edward Ferguson, PH.D.
• Samantha Ferguson, PA-C
• Eric Fernandez, LMT
• Shaneen S Fernandez, DNP, CNM, ARNP
• Aurora Claire Fernwood, M.S., LMFT
• Amihan A Ferrer, M.D.
• Alicia Ferris, M.S., LMHC

• Counselor in Olympia, WA
• Providers in Olympia, WA by specialty
• Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.