Individual provider Active NPI

Marjorie Gidwitz-Ferguson, LCSW

  • Clinical Social Worker
  • Roanoke, VA
National Provider Identifier
1730065210
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904013451 Issued in VA
Practice address
4919 Brambleton Ave
Roanoke, VA 24018-4149
Phone
(540) 685-4298
Fax
(540) 685-4299
NPI assigned
Aug 12, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0904013451 VA
Professional Counselor 101YP2500X 0904013451
Marriage & Family Therapist 106H00000X 0904013451 VA
Clinical Social Worker 1041C0700X 0904013451 VA Primary

Addresses

Primary practice location

4919 Brambleton Ave
Roanoke, VA 24018-4149

Mailing address

4919 Brambleton Ave
Roanoke, VA 24018-4149
Phone (540) 685-4298

Other practice location 1

235 Claiborne Ave Ste 200
Rocky Mount, VA 24151-1439
Phone (540) 238-2080

Other identifiers 1

IdentifierTypeStateIssuer
1910MedicaidVA

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
0904013451VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix LLC PastSince Aug 17, 2025 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": "1754956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1730065210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4919 BRAMBLETON AVE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240184149",
            "telephone_number": "540-685-4298",
            "fax_number": "540-685-4299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4919 BRAMBLETON AVE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240184149",
            "telephone_number": "540-685-4298",
            "fax_number": "540-685-4299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "235 Claiborne Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Rocky Mount",
            "state": "VA",
            "postal_code": "241511439",
            "country_code": "US",
            "telephone_number": "540-238-2080",
            "fax_number": "540-238-2081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIDWITZ-FERGUSON",
        "first_name": "MARJORIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-12",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0904013451",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": "0904013451",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0904013451",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904013451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1910",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; 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.