Individual provider Active NPI

Casey A Ferguson, MS, LMHP, CPC

  • Mental Health Counselor
  • Council Bluffs, IA
National Provider Identifier
1649431925
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3360 Issued in NE
Practice address
500 Willow Ave
Suite 305
Council Bluffs, IA 51503-0827
Phone
(712) 256-4420
Fax
(712) 256-4423
NPI assigned
Jun 19, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3360 NE Primary

Addresses

Primary practice location

500 Willow Ave
Suite 305
Council Bluffs, IA 51503-0827

Mailing address

500 Willow Ave
Suite 305
Council Bluffs, IA 51503-0827
Phone (712) 256-4420

Other identifiers 2

IdentifierTypeStateIssuer
1010744MedicaidIA
100253517-00MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231214003544 NE Practitioner - Mental Health Counselor 3072962083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton HealthGroup PAC ID 1850285255, 137 clinicians

Practice addresses (Care Compare)

7101 Newport Ave
Omaha, NE 68152-2164
Phone (402) 572-2905

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3360NEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Health CurrentSince Jan 1, 2024 Accepting new patients
Alegent Creighton Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

7101 Newport Ave
Omaha, NE 68152
Phone (402) 572-2905

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

Organizations & group practices 2

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": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213833600000",
    "number": "1649431925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WILLOW AVE",
            "address_2": "SUITE 305",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515030827",
            "telephone_number": "712-256-4420",
            "fax_number": "712-256-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WILLOW AVE",
            "address_2": "SUITE 305",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515030827",
            "telephone_number": "712-256-4420",
            "fax_number": "712-256-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "CASEY",
        "middle_name": "A",
        "credential": "MS, LMHP, CPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-19",
        "last_updated": "2008-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "3360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010744",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100253517-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

Verify at the official NPI Registry.