Provider Demographics
NPI:1144415696
Name:FARRINGTON, STACY L (LCSW)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:L
Last Name:FARRINGTON
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 1:3530 N COUNTY RD E # F
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53548-9074
Mailing Address - Country:US
Mailing Address - Phone:608-758-8412
Mailing Address - Fax:
Practice Address - Street 1:3530 N COUNTY RD E # F
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53548-9074
Practice Address - Country:US
Practice Address - Phone:608-758-8412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14681231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39625800Medicaid