Individual provider Active NPI

Andrew Ferguson, LCSW-C

  • Clinical Social Worker
  • Middletown, MD
National Provider Identifier
1710152335
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
17207 Issued in MD
Practice address
101 E Green St
Middletown, MD 21769-7908
Phone
(301) 788-9360
NPI assigned
Apr 24, 2008
Last updated
Jan 4, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 17207 MD Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

101 E Green St
Middletown, MD 21769-7908

Mailing address

8003 Clearfield Rd
Frederick, MD 21702-2903
Phone (301) 788-9360

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
17207MDMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1710152335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8003 CLEARFIELD RD",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217022903",
            "telephone_number": "301-788-9360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E GREEN ST",
            "city": "MIDDLETOWN",
            "state": "MD",
            "postal_code": "217697908",
            "telephone_number": "301-788-9360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "ANDREW",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-24",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "17207",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; 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.