Christine Adaline Ferguson LSW, Licdc LLC

Primary specialty

Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X

Legal business name

CHRISTINE ADALINE FERGUSON LSW, LICDC LLC

Practice address

16360 Broadway Ave Ste B101
Maple Heights, OH 44137-2573

Phone

(216) 510-7170

Fax

(216) 510-7213

NPI assigned

Oct 4, 2022

Organization subpart

Yes

Parent organization

CHRISTINE ADALINE FERGUSON, LSW-LICDC LLCAs reported in NPPES

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

Authorized official

Name

Christine A Ferguson, LISWNPI 1831635002

Title

Director

Phone

(216) 727-6410

Specialties & licenses 1

Addresses

Other names 1

• Key Counseling Services Doing business as

Electronic endpoints 2

Tax ID family

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

Part of

Christine Adaline Ferguson LSW Licdc LLC

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

  • Community/Behavioral Health Agency
  • Maple Heights, OH
  • NPI 1326674052
  NPD tax ID

Interoperability endpoints

• Direct secure messaging: christineadaline@keycounselorcom.onmicrosoft.ccom

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Christine Adaline Ferguson LSW, Licdc LLC

  • Community/Behavioral Health Agency
  • Maple Heights, OH
  • NPI 1326674052
  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
  NPD Authorized official

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664841600000",
    "number": "1679298491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18320 MAPLEBORO AVE",
            "city": "MAPLE HEIGHTS",
            "state": "OH",
            "postal_code": "441372768",
            "telephone_number": "216-727-6410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16360 BROADWAY AVE STE B101",
            "city": "MAPLE HEIGHTS",
            "state": "OH",
            "postal_code": "441372573",
            "telephone_number": "216-510-7170",
            "fax_number": "216-510-7213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTINE ADALINE FERGUSON LSW, LICDC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHRISTINE ADALINE FERGUSON, LSW-LICDC LLC",
        "enumeration_date": "2022-10-04",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A",
        "authorized_official_last_name": "FERGUSON",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "216-727-6410",
        "authorized_official_credential": "LISW"
    },
    "taxonomies": [
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Christineadaline@keycounselorcom.onmicrosoft.ccom",
            "affiliation": "N",
            "endpointDescription": "office email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "16360 Broadway Ave Ste B101",
            "city": "Maple Heights",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441372573",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.keycounservices.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "16360 Broadway Ave Ste B101",
            "city": "Maple Heights",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441372573",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Key Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 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
• Candice Clements

• Children's Substance Abuse Rehabilitation Facility in Maple Heights, OH
• Providers in Maple Heights, OH by specialty
• Children's Substance Abuse Rehabilitation Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.