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General NPI Number Information
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NPI Number | 1093523268
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Entity Type | Individual
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Provider Name | JAMIE MARIE FARAONE LAAC, LICDC, CAADC
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Gender | Female
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Dates
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Enumeration Date | 12/20/2024
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Last Update Date | 01/22/2026
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Provider Practice Location Address
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Address Line | 145 W VINE ST
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City | NEW WILMINGTON
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State | PA
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Zip | 16142-1203
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Country | US
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Telephone | 480-766-8277
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Fax |
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Provider Business Mailing Address
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Address Line | 145 W VINE ST
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City | NEW WILMINGTON
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State | PA
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Zip | 16142-1203
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Country | US
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Telephone | 480-766-8277
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Fax |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LICDC.162953
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 25-R-39
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LAAC-15573
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License Number State | AZ
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