Healthcare Provider Details

I. General information

NPI: 1508239229
Provider Name (Legal Business Name): CHARLOTTE FARRIS LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2015
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 N MAYSVILLE ST
MOUNT STERLING KY
40353-1471
US

IV. Provider business mailing address

29 N MAYSVILLE ST
MOUNT STERLING KY
40353-1471
US

V. Phone/Fax

Practice location:
  • Phone: 185-952-0304
  • Fax: 859-432-8935
Mailing address:
  • Phone: 859-404-0810
  • Fax: 859-585-3005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number175330
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number175330
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: