Active NPI
Debra Ferguson, PH.D.
- Clinical Psychologist
- Oakton, VA
National Provider Identifier
1679921043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0810005238
- Practice address
- 10300 Bushman Dr
#300
Oakton, VA 22124-1704 - Phone
- (703) 705-2922
- NPI assigned
- May 26, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 Psychologist | 103TC0700X | 071005928 | IL | |
| Clinical Psychologist | 103TC0700X | 0810005238 | VA | Primary |
Addresses
Primary practice location
10300 Bushman Dr
#300
Oakton, VA 22124-1704
Mailing address
2961A Hunter Mill Rd # 642
Oakton, VA 22124-1704
Phone (312) 543-5107
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161115001519 | DC | Practitioner - Clinical Psychologist | 4880973874 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
10300 Bushman Dr
Apt 309
Oakton, VA 22124-2826
Phone (703) 705-2922
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071005928 | IL | MD | Clinical Psychologist |
| 0810005238 | VA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 4 Roses Psychological Services. PLLC | Current | Accepting new patients |
Locations
2961A Hunter Mill Rd
Oakton, VA 22124
Phone (703) 914-3237
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": "1464220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664928000000",
"number": "1679921043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2961A HUNTER MILL RD # 642",
"city": "OAKTON",
"state": "VA",
"postal_code": "221241704",
"telephone_number": "312-543-5107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10300 BUSHMAN DR",
"address_2": "#300",
"city": "OAKTON",
"state": "VA",
"postal_code": "221241704",
"telephone_number": "703-705-2922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERGUSON",
"first_name": "DEBRA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-05-26",
"last_updated": "2022-10-05",
"certification_date": "2022-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071005928",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810005238",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oakton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.