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General NPI Number Information
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NPI Number | 1457943094
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Entity Type | Individual
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Provider Name | JESSICA FARMER LCSWA
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Gender | Female
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Dates
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Enumeration Date | 02/05/2021
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Last Update Date | 02/05/2021
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Provider Practice Location Address
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Address Line | 5171 GLENWOOD AVE STE 211
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City | RALEIGH
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State | NC
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Zip | 27612-3266
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Country | US
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Telephone | 919-865-8710
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Fax |
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Provider Business Mailing Address
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Address Line | 519 HESWALL CT
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City | ROLESVILLE
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State | NC
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Zip | 27571-9587
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Country | US
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Telephone | 828-242-4103
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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 | P015392
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License Number State | NC
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