Provider Demographics
NPI:1386662997
Name:FARNHAM, JAMES G (MA, LICSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:G
Last Name:FARNHAM
Suffix:
Gender:M
Credentials:MA, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COLONY CARE BEHAVIORAL HEALTH
Mailing Address - Street 2:841 MAIN STREET
Mailing Address - City:WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02081
Mailing Address - Country:US
Mailing Address - Phone:508-404-3334
Mailing Address - Fax:508-660-6658
Practice Address - Street 1:COLONY CARE BEHAVIORAL HEALTH
Practice Address - Street 2:841 MAIN STREET
Practice Address - City:WALPOLE
Practice Address - State:MA
Practice Address - Zip Code:02081
Practice Address - Country:US
Practice Address - Phone:508-404-3334
Practice Address - Fax:508-660-6658
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0049671041C0700X
MA1141171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical