Provider Demographics
NPI:1093177347
Name:FARLEY, LEAH (MA, LMFTA)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:FARLEY
Suffix:
Gender:F
Credentials:MA, LMFTA
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:
Other - Last Name:MONAHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LMFTA
Mailing Address - Street 1:3710 SHANNON RD # 52703
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6327
Mailing Address - Country:US
Mailing Address - Phone:984-223-9915
Mailing Address - Fax:
Practice Address - Street 1:3710 SHANNON RD # 52703
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6327
Practice Address - Country:US
Practice Address - Phone:984-223-9915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-25
Last Update Date:2021-01-22
Deactivation Date:2019-08-12
Deactivation Code:
Reactivation Date:2020-02-26
Provider Licenses
StateLicense IDTaxonomies
NC10090A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist