Healthcare Provider Details

I. General information

NPI: 1740657980
Provider Name (Legal Business Name): NICHOLAS FARKAS LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2015
Last Update Date: 12/19/2024
Certification Date: 12/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2108 SW 152ND ST STE E
BURIEN WA
98166-2069
US

IV. Provider business mailing address

2108 SW 152ND ST STE E
BURIEN WA
98166-2069
US

V. Phone/Fax

Practice location:
  • Phone: 253-260-3557
  • Fax:
Mailing address:
  • Phone: 860-480-6161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCG 60642539
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberCO 60604805
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: