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General NPI Number Information
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NPI Number | 1154139970
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Entity Type | Individual
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Provider Name | SAMANTHA FARLEY LCSWA
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Gender |
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Dates
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Enumeration Date | 12/26/2024
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Last Update Date | 12/26/2024
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Provider Practice Location Address
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Address Line | 1515 W NC HIGHWAY 54 STE 220
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City | DURHAM
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State | NC
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Zip | 27707-5576
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Country | US
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Telephone | 919-297-8322
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Fax |
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Provider Business Mailing Address
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Address Line | 305 GRESHAM AVE
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City | DURHAM
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State | NC
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Zip | 27704-4211
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Country | US
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Telephone | 919-699-6120
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P021479
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License Number State | NC
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