Individual provider Active NPI

Jessica Racheel Ferguson, LPC

  • Professional Counselor
  • Fort Worth, TX
National Provider Identifier
1205352770
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
74303 Issued in TX
Practice address
2684 Gardendale Drive
Fort Worth, TX 76120
Phone
(817) 458-6838
NPI assigned
Aug 16, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 74303 TX Primary

Addresses

Primary practice location

2684 Gardendale Drive
Fort Worth, TX 76120

Mailing address

2684 Gardendale Dr
Fort Worth, TX 76120-5627
Phone (817) 458-6838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
74303TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Professional Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jessicaferguson@tdh.allscriptsdirect.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1205352770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2684 GARDENDALE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761205627",
            "telephone_number": "817-458-6838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2684 GARDENDALE DRIVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76120",
            "telephone_number": "817-458-6838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "JESSICA",
        "middle_name": "RACHEEL",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "74303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.