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General NPI Number Information
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NPI Number | 1619622206
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Entity Type | Individual
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Provider Name | TAMARA FARRIS
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Gender | Female
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Dates
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Enumeration Date | 02/13/2022
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 3111 SPRINGBANK LN STE I
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City | CHARLOTTE
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State | NC
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Zip | 28226-3373
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Country | US
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Telephone | 855-675-4144
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Fax | 617-807-0958
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Provider Business Mailing Address
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Address Line | 108F N READING RD # 18671721
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City | EPHRATA
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State | PA
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Zip | 17522-1668
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Country | US
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Telephone | 717-219-5711
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Fax | 717-219-5712
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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 | SW138658
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P020224
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License Number State | NC
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