Provider Demographics
NPI:1114115144
Name:FARRAR, MELISSA PRICE (LCSW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:PRICE
Last Name:FARRAR
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 1:5100 POPLAR AVE
Mailing Address - Street 2:SUITE 2700 PMB 108
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38137-4000
Mailing Address - Country:US
Mailing Address - Phone:901-491-6966
Mailing Address - Fax:
Practice Address - Street 1:5100 POPLAR AVE
Practice Address - Street 2:27TH FLOOR
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38137-4000
Practice Address - Country:US
Practice Address - Phone:901-491-6966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN47891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical