Ferlicia Fergusson-Prudent, PSYD, LMHC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY61370639 Issued in WA

Practice address

309 E Main St Ste 5
Auburn, WA 98002-5540

Phone

(253) 434-3825

NPI assigned

Aug 27, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Prudent Psychological Services

  • Mental Health Counselor
  • Auburn, WA
  • NPI 1386429082
  Medicare reassignment NPD Authorized official
• Sandbox Therapy Group, Inc.

  • Psychologist
  • Redmond, WA
  • NPI 1205378825

  Mental Health

  NPD (past)
• Daybreak Medical PA

  • Mental Health Counselor
  • Dallas, TX
  • NPI 1255060091
  NPD (past)

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1205317211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 E MAIN ST STE 5",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980025540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E MAIN ST STE 5",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980025540",
            "telephone_number": "253-434-3825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSSON-PRUDENT",
        "first_name": "FERLICIA",
        "name_prefix": "Dr.",
        "credential": "PSYD, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-27",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC6081228",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY61370639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Featherstone
• Erik Anthony Feider, D.D.S.
• Joel Felipe, MD
• Matthew D Fenstermaker, PT, DPT
• Courtney Ferguson, PTA
• Aiko Fernandez
• Rafael Ferrer Morales
• Tracy Ferry
• Ffata 4 GGG, LLC (Amada Senior Care)
• Andrew Field, DPT

• Clinical Psychologist in Auburn, WA
• Providers in Auburn, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.