Healthcare Provider Details

I. General information

NPI: 1336406420
Provider Name (Legal Business Name): WHITNEY E FARRAR M.ED, LPCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2012
Last Update Date: 02/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 E MAIN ST
PARIS KY
40361-2126
US

IV. Provider business mailing address

269 E MAIN ST
PARIS KY
40361-2126
US

V. Phone/Fax

Practice location:
  • Phone: 859-987-6127
  • Fax:
Mailing address:
  • Phone: 859-987-6127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number00216569
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: