Provider Demographics
NPI:1376954289
Name:FARR, JONATHAN (LMHC)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:FARR
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 WASHINGTON DR
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-3132
Mailing Address - Country:US
Mailing Address - Phone:617-329-1075
Mailing Address - Fax:617-221-3956
Practice Address - Street 1:60 WASHINGTON DR
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-3132
Practice Address - Country:US
Practice Address - Phone:617-329-1075
Practice Address - Fax:617-221-3956
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-13
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10134101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional