Provider Demographics
NPI:1083055719
Name:DE ARMOND-FARRELL, THERESA L (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:L
Last Name:DE ARMOND-FARRELL
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 84614
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85071-4614
Mailing Address - Country:US
Mailing Address - Phone:602-574-6544
Mailing Address - Fax:623-937-0415
Practice Address - Street 1:8841 N 1ST ST BLDG A
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2801
Practice Address - Country:US
Practice Address - Phone:602-574-6544
Practice Address - Fax:623-937-0415
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-10
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ14077101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health