Active NPI
Ellen Ferguson
- Mental Health Counselor
- Port Charlotte, FL
National Provider Identifier
1770063034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH16265
- Practice address
- 3191 Harbor Blvd
Port Charlotte, FL 33952-6755 - Phone
- (941) 883-4518
- NPI assigned
- Aug 16, 2018
- Last updated
- Aug 16, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH16265 | FL | Primary |
Addresses
Primary practice location
3191 Harbor Blvd
Port Charlotte, FL 33952-6755
Mailing address
6360 Techster Blvd Ste 1
Fort Myers, FL 33966-4805
Phone (239) 223-2751
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
| License | State | Type | Specialty |
|---|---|---|---|
| MH16265 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534377600000",
"number": "1770063034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6360 TECHSTER BLVD STE 1",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339664805",
"telephone_number": "239-223-2751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3191 HARBOR BLVD",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339526755",
"telephone_number": "941-883-4518"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERGUSON",
"first_name": "ELLEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-16",
"last_updated": "2018-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH16265",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Charlotte, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.