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NPI 1225483704

NPI 1225483704 : LYNDI N FARNAM, LLC : HAHIRA, GA

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General NPI Number Information
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    NPI Number           |    1225483704
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    Entity Type          |    Organization 
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    Legal Business Name  |    LYNDI N FARNAM, LLC 
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Dates
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    Enumeration Date     |    05/03/2016
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    Last Update Date     |    09/08/2025
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Provider Practice Location Address
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    Address Line         |    505 S CHURCH ST STE 4C 
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    City                 |    HAHIRA
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    State                |    GA
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    Zip                  |    31632-1413
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    Country              |    US
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    Telephone            |    406-565-0064
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    505 S CHURCH ST STE 4C 
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    City                 |    HAHIRA
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    State                |    GA
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    Zip                  |    31632-1413
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    Country              |    US
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    Telephone            |    406-565-0064
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     LYNDI  FARNAM 
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    Credential           |    LCSW
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    Telephone            |    406-565-0064
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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       |    CSW005216
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    License Number State |    GA
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