Dallas Lane Ferguson | Stafford, TX • PECOS Search

Dallas Lane Ferguson

Counselor

Behavioral Health & Social Service Providers

10701 Corporate Dr, Suite 205, Stafford, TX 77477-4096

PECOS Enrollment

Based on the most recent information from CMS, provider Dallas Lane Ferguson does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1417289620
Provider Type
Individual
Full Name
Ferguson, Dallas Lane
Credential
LPC

Gender
Female
Sole Proprietor
Yes
Enumeration Date
2/12/2010
Last Updated
2/12/2010

Contact Information

Practice Location

10701 Corporate Dr, Suite 205, Stafford, TX 77477-4096

Unlisted Fax

Mailing Location

10701 Corporate Dr, Suite 205, Stafford, TX 77477-4096

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YP2500X Primary	Description Counselor Behavioral Health & Social Service Providers	License 15308 Texas