Paul Don Fergeson, MA-PSYCH, AAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CG61366933 Issued in WA

Practice address

4526 Federal Ave
Everett, WA 98203-2132

Phone

(425) 349-6200

NPI assigned

Sep 14, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1548718042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4526 FEDERAL AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982032132",
            "telephone_number": "425-349-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4526 FEDERAL AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982032132",
            "telephone_number": "425-349-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGESON",
        "first_name": "PAUL",
        "middle_name": "DON",
        "credential": "MA-PSYCH, AAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-14",
        "last_updated": "2022-11-02",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CG61366933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALITY MENTAL HEALTH PROFESSIONAL",
            "identifier": "0732002186",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHEMICAL DEPENDENCY COUNSELOR II",
            "identifier": "8434",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED SUBSTANCE COUNSELOR",
            "identifier": "0710101785",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan C. Fenner, M.A., LMHC
• Amanda Fenrich, MA
• Federico Fenton Portillo, M.D.
• Thoa Phan Fenton, ARNP
• Melanie Aileen Louise Ferenczy, BSW, AAC-R
• Erin K Ferguson
• Kadi-Ann Ferguson
• Amber S Fernandez
• Jason Fernandez, CMA
• Rosane Jane Fernandez, M.D.

• Mental Health Counselor in Everett, WA
• Providers in Everett, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.