Provider Demographics
NPI:1033576442
Name:MACFARLANE, JOHN KENT (RMHC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:KENT
Last Name:MACFARLANE
Suffix:
Gender:M
Credentials:RMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4848 CLARA KEE CT
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-7161
Mailing Address - Country:US
Mailing Address - Phone:719-320-4030
Mailing Address - Fax:
Practice Address - Street 1:4848 CLARA KEE CT
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-7161
Practice Address - Country:US
Practice Address - Phone:719-320-4030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-15
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH 13674101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101YM0800XOtherCENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS), THE NATIONAL UNIFORM CLAIM COM
FL101YP2500XOtherCENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS), THE NATIONAL UNIFORM CLAIM COM