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General NPI Number Information
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NPI Number | 1174239081
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Entity Type | Individual
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Provider Name | FAREN FREDERICK MSW,LMSW,MSPC
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Gender | Female
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Dates
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Enumeration Date | 01/24/2023
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 14321 WINTER BREEZE DR
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City | MIDLOTHIAN
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State | VA
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Zip | 23113-2452
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Country | US
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Telephone | 833-452-9772
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Fax |
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Provider Business Mailing Address
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Address Line | 3501 CHIMNEY HILL CT APT 102
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-7045
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Country | US
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Telephone |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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