Individual provider Active NPI

Jennifer Hortense Ferguson, LMFT

  • Marriage & Family Therapist
  • Lakewood, WA
National Provider Identifier
1669654505
Registry record updated Sep 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LF60079410 Issued in WA
Practice address
9124 Gravelly Lake Dr SW
Lakes Plaza Suite 101
Lakewood, WA 98499-3198
Phone
(253) 503-0236
Fax
(253) 503-0982
NPI assigned
Dec 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CPOOOO5222 WA
Marriage & Family Therapist 106H00000X MG60171687 WA
Marriage & Family Therapist 106H00000X LF60079410 WA Primary

Addresses

Primary practice location

9124 Gravelly Lake Dr SW
Lakes Plaza Suite 101
Lakewood, WA 98499-3198

Mailing address

9124 Gravelly Lake Dr SW
Lakes Plaza Suite 101
Lakewood, WA 98499-3198
Phone (253) 503-0236

Other identifiers 1

IdentifierTypeStateIssuer
331-8907MedicaidWA

Other names 1

  • Ms. Jennifer Armstrong Ferguson Former name

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
CPOOOO5222WAMDAddiction (Substance Use Disorder) Counselor
LF60079410WAMDMarriage & Family Therapist
MG60171687WAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
L.I.G.H.T. Counseling Center Past Accepting new patients

Organizations & group practices 1

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": "1196640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316390400000",
    "number": "1669654505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9124 GRAVELLY LAKE DR SW",
            "address_2": "LAKES PLAZA SUITE 101",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993198",
            "telephone_number": "253-503-0236",
            "fax_number": "253-503-0982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9124 GRAVELLY LAKE DR SW",
            "address_2": "LAKES PLAZA SUITE 101",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993198",
            "telephone_number": "253-503-0236",
            "fax_number": "253-503-0982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "JENNIFER",
        "middle_name": "HORTENSE",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-03",
        "last_updated": "2011-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CPOOOO5222",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "MG60171687",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF60079410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "331-8907",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "FERGUSON",
            "middle_name": "ARMSTRONG",
            "prefix": "MS.",
            "credential": "MA, LMFT, CDP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2011; 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.