Provider Demographics
NPI:1164515409
Name:FARMER, CLARA LANETTE (LSCSW)
Entity Type:Individual
Prefix:
First Name:CLARA
Middle Name:LANETTE
Last Name:FARMER
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1181 SW FILLMORE ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-1169
Mailing Address - Country:US
Mailing Address - Phone:785-969-2288
Mailing Address - Fax:785-232-4124
Practice Address - Street 1:214 SW 7TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66603-3717
Practice Address - Country:US
Practice Address - Phone:785-969-2288
Practice Address - Fax:785-232-4124
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-01
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS20721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS070492Medicare ID - Type Unspecified