Christine Adaline Ferguson LSW, Licdc LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

CHRISTINE ADALINE FERGUSON LSW, LICDC LLC

Doing business as

Key Counseling Services

Practice address

16360 Broadway Ave Ste 21016360
Maple Heights, OH 44137-2555

Phone

(216) 865-5050

NPI assigned

Mar 13, 2020

Organization subpart

No

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

Authorized official

Name

Christine A Ferguson, LICDC 161363NPI 1831635002

Title

Owner/Provider

Phone

(216) 865-5050

Specialties & licenses 1

Addresses

Other names 1

• Key Counseling Services Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Tax ID family

Christine Adaline Ferguson LSW Licdc LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Christine Adaline Ferguson LSW, Licdc LLC

  • Children's Substance Abuse Rehabilitation Facility
  • Maple Heights, OH
  • NPI 1679298491
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Christine Adaline Ferguson LSW, Licdc LLC

  • Children's Substance Abuse Rehabilitation Facility
  • Maple Heights, OH
  • NPI 1679298491
  NPPES parent name

Practitioners 1

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

• Christine A Ferguson, LICDC-LISW

  • Clinical Social Worker
  • Maple Heights, OH
  • NPI 1831635002
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1584057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669161600000",
    "number": "1326674052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16360 BROADWAY AVE STE 21016360",
            "city": "MAPLE HEIGHTS",
            "state": "OH",
            "postal_code": "441372555",
            "telephone_number": "216-865-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16360 BROADWAY AVE STE 21016360",
            "city": "MAPLE HEIGHTS",
            "state": "OH",
            "postal_code": "441372555",
            "telephone_number": "216-865-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTINE ADALINE FERGUSON LSW, LICDC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-13",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A",
        "authorized_official_last_name": "FERGUSON",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "216-865-5050",
        "authorized_official_credential": "LICDC 161363"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Key Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Key Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tracy Lynette Chavis
• Shineka Chestnut, LPN
• Nolan Dewitt Childress Jr.
• Choices, Adult Day Center LLC
• Shaunte Denise Christian
• Christine Adaline Ferguson LSW, Licdc LLC
• Anthonia Ndali Chukwudelunzu, FNP
• City of Maple Heights
• Alexus Clark
• April Anne Clark

• Community/Behavioral Health Agency in Maple Heights, OH
• Providers in Maple Heights, OH by specialty
• Community/Behavioral Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.