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General NPI Number Information
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NPI Number | 1023246766
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Entity Type | Individual
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Provider Name | NICOLE FARRIS MS/EDS, LCPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 07/01/2009
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Last Update Date | 02/08/2010
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Provider Practice Location Address
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Address Line | 18221-D FLOWER HILL WAY
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City | GAITHERSBURG
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State | MD
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Zip | 20879-5333
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Country | US
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Telephone | 301-219-8559
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Fax |
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Provider Business Mailing Address
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Address Line | 12301 SILVERGATE WAY # 906E
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City | GERMANTOWN
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State | MD
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Zip | 20874-2548
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Country | US
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Telephone | 301-219-8559
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Fax | 301-731-2082
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LC3320
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License Number State | MD
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