Active NPI
Tamera Naneke Ferguson, LCSW
- Clinical Social Worker
- Lawrenceville, GA
National Provider Identifier
1396892360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW004319
- Practice address
- 405 Philip Blvd
Apt 710
Lawrenceville, GA 30046-8738 - Phone
- (706) 540-6477
- Fax
- (770) 962-3842
- NPI assigned
- Jan 4, 2007
- Last updated
- Dec 1, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW004319 | GA | Primary |
| School Social Worker | 1041S0200X | 434377 | GA |
Addresses
Primary practice location
405 Philip Blvd
Apt 710
Lawrenceville, GA 30046-8738
Mailing address
405 Philip Blvd
Apt 710
Lawrenceville, GA 30046-8738
Phone (706) 540-6477
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
| License | State | Type | Specialty |
|---|---|---|---|
| CSW004319 | GA | MD | Clinical Social Worker |
| 434377 | GA | MD | School Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291161600000",
"number": "1396892360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 PHILIP BLVD",
"address_2": "APT 710",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300468738",
"telephone_number": "706-540-6477",
"fax_number": "770-962-3842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 PHILIP BLVD",
"address_2": "APT 710",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300468738",
"telephone_number": "706-540-6477",
"fax_number": "770-962-3842"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERGUSON",
"first_name": "TAMERA",
"middle_name": "NANEKE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-04",
"last_updated": "2010-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "CSW004319",
"primary": true
},
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "GA",
"license": "434377",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.