Individual provider Active NPI

Elizabeth Rosemary Ferguson, LISW

  • Clinical Social Worker
  • Cincinnati, OH
National Provider Identifier
1316503337
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2203616 Issued in OH
Practice address
4050 Executive Park Dr Ste 350
Cincinnati, OH 45241-2077
Phone
(513) 275-6023
Fax
(513) 672-2740
NPI assigned
May 15, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 253807 KY
Social Worker 104100000X S.1903515 OH
Clinical Social Worker 1041C0700X I.2203616 OH Primary

Addresses

Primary practice location

4050 Executive Park Dr Ste 350
Cincinnati, OH 45241-2077

Mailing address

1251 Nilles Rd Ste 5
Fairfield, OH 45014-7205
Phone (513) 939-0300

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
253807KYMDSocial Worker
S.1903515OHMDSocial Worker
I.2203616OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1316503337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 NILLES RD STE 5",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450147205",
            "telephone_number": "513-939-0300",
            "fax_number": "513-939-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 EXECUTIVE PARK DR STE 350",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452412077",
            "telephone_number": "513-275-6023",
            "fax_number": "513-672-2740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "ELIZABETH",
        "middle_name": "ROSEMARY",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-15",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KY",
            "license": "253807",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1903515",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2203616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; 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.