| Doctor Name: | JILL CHARLENE FERGUSON |
| NPI Number: | 1821415068 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | MF000735 |
| Business Practice Address: | 200 Renaissance Drive Suite 301 Butler, PA - 16001 |
| Business Phone Number: | 7242871880 |
| Business Fax Number: | 7242821848 |
| Mailing Address: | 365 Franklin Hill Road, KITTANNING |
| State: | PA |
| Postal Code: | 16201 |
| Phone Number: | 7245431888 |
| Fax Number: | 7245431898 |
| NPI Enumeration Date: | 03/26/2014 |
| NPI Last Update Date: | 03/26/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | MF000735 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |