MEDICARE: ALICIA RENEE FARMER LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	A1001001	AR
2	101YM0800X	Mental Health Counselor	P1306060	AR

General Provider Information

NPI Number	:	1134452071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA RENEE FARMER LPC

Provider Business Mailing Address
First Line	:	2400 S 48TH STREET
Second Line	:	SUITE 1400
City	:	SPRINGDALE
State	:	AR
Zip	:	72762
Country	:	US
Telephone Number	:	479-750-2020
Fax Number	:	479-750-4843

Provider Business Practice Location Address
First Line	:	1200 W WALNUT ST
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72756-3521
Country	:	US
Telephone Number	:	479-725-6000
Fax Number	:	479-750-4843

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2009
Last Update Date	:	10/16/2015

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Directions to “ ALICIA RENEE FARMER LPC” Practice Location

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