MEDICARE: KAREN RENEE FARRAR LLMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker
2	1041C0700X	Clinical Social Worker	6801093319	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396021242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN RENEE FARRAR LLMSW

Provider Business Mailing Address
First Line	:	1344 CHESTNUT CIR
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48309-1714
Country	:	US
Telephone Number	:	248-891-0991
Fax Number	:

Provider Business Practice Location Address
First Line	:	1344 CHESTNUT CIR
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48309
Country	:	US
Telephone Number	:	248-891-0991
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2011
Last Update Date	:	07/09/2018

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