Provider Demographics
NPI:1003973603
Name:FARLOW, REBECCA HOOKS (LCSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:HOOKS
Last Name:FARLOW
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8320 UNIVERSITY EXEC PARK DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-1338
Mailing Address - Country:US
Mailing Address - Phone:704-549-8797
Mailing Address - Fax:407-549-1479
Practice Address - Street 1:8320 UNIVERSITY EXEC PARK DR
Practice Address - Street 2:STE 104
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-1338
Practice Address - Country:US
Practice Address - Phone:704-549-8797
Practice Address - Fax:704-549-1479
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC003402101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health