| Doctor Name: | JOHN DWIGHT FERGUSON |
| NPI Number: | 1588744304 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LICSW |
| License Number: | 10199 |
| Business Practice Address: | 1340 81st Ave Ne Spring Lake Park, MN - 554322116 |
| Business Phone Number: | 7637834528 |
| Business Fax Number: | 7637869729 |
| Mailing Address: | 5648 Newton Ave S, MINNEAPOLIS |
| State: | MN |
| Postal Code: | 554191531 |
| Phone Number: | 6129222993 |
| Fax Number: | |
| NPI Enumeration Date: | 10/16/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 10199 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |