Provider Demographics
NPI:1427709203
Name:FERGERSON, CHERYL LYNN (DSW, LMSW, ACHP-SW)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:LYNN
Last Name:FERGERSON
Suffix:
Gender:F
Credentials:DSW, LMSW, ACHP-SW
Other - Prefix:DR
Other - First Name:CHERYL
Other - Middle Name:
Other - Last Name:FERGERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DSW, LMSW, ACHP-SW
Mailing Address - Street 1:965 RIDGE LAKE BLVD STE 315
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-9401
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:901-227-8591
Practice Address - Street 1:6215 HUMPHREYS BLVD STE 301
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2382
Practice Address - Country:US
Practice Address - Phone:901-227-9875
Practice Address - Fax:901-763-3694
Is Sole Proprietor?:No
Enumeration Date:2022-01-13
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10237104100000X
TN82961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker