MEDICARE: CARMEN FARRO GEHRKE LPC, LPCMH

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	101YP2500X	Professional Counselor	PC006378	PA
2	101YP2500X	Professional Counselor	PC-0000618	DE
3	101YM0800X	Mental Health Counselor	MH14612	FL

General Provider Information

NPI Number	:	1871857524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARMEN FARRO GEHRKE LPC, LPCMH

Provider Business Mailing Address
First Line	:	342 CARAVELLE DR
Second Line	:
City	:	JUPITER
State	:	FL
Zip	:	33458-8207
Country	:	US
Telephone Number	:	651-602-0833
Fax Number	:	561-656-2099

Provider Business Practice Location Address
First Line	:	800 VILLAGE SQUARE XING STE 109
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4540
Country	:	US
Telephone Number	:	561-602-0833
Fax Number	:	561-656-2099

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

Provider Enumeration Date	:	06/27/2012
Last Update Date	:	07/21/2022

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