Provider Demographics
NPI:1124046123
Name:FARMER, AMY JO (MSW, LCSW, RPT)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:JO
Last Name:FARMER
Suffix:
Gender:F
Credentials:MSW, LCSW, RPT
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 429
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-0429
Mailing Address - Country:US
Mailing Address - Phone:317-250-0963
Mailing Address - Fax:317-770-7886
Practice Address - Street 1:407 S 9TH ST
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-2733
Practice Address - Country:US
Practice Address - Phone:317-250-0963
Practice Address - Fax:317-770-7886
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34003267A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical