Kerry Brock Ferguson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY6092 Issued in FL

Practice address

442 N Dillard St Ste 1
Winter Garden, FL 34787-2818

Phone

(352) 536-9737

Fax

(407) 614-1900

NPI assigned

Aug 8, 2006

Last updated

Sep 14, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Kerry Lynn Brock Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Resilient Living Solutions, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Winter Garden, FL
  • NPI 1992288922
  NPD (past) Authorized official

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1992714703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 809",
            "city": "MINNEOLA",
            "state": "FL",
            "postal_code": "347550809",
            "telephone_number": "352-536-9737",
            "fax_number": "321-939-3652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 N DILLARD ST STE 1",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347872818",
            "telephone_number": "352-536-9737",
            "fax_number": "407-614-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "KERRY",
        "middle_name": "BROCK",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY6092",
            "primary": false
        },
        {
            "code": "103TE1100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Exercise & Sports",
            "state": "FL",
            "license": "PY6092",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "FL",
            "license": "PY6092",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY6092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERRY",
            "last_name": "BROCK",
            "middle_name": "LYNN",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cole Feffer, M.D.
• Yassel Feliciano Colon, M.A. SLP-CF
• Rachelle Felix
• Henrique Felski
• Shaneika Felton
• Alexa Fernandez-Botero, LCSW
• Jorge Luis Fernandez, MA 101050
• Richard Fernandez
• Samantha Fernandez, LMHC
• Guilherme Ferrari Alves Ruggeri, BEHAVIOR TECHNICIAN

• Clinical Psychologist in Winter Garden, FL
• Providers in Winter Garden, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.

Verify at the official NPI Registry.