Provider Demographics
NPI:1467837849
Name:FARMER, KATHARINE A (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:A
Last Name:FARMER
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 1:11 SWEZEY LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLE ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:11953-1440
Mailing Address - Country:US
Mailing Address - Phone:845-219-2619
Mailing Address - Fax:
Practice Address - Street 1:11 SWEZEY LN
Practice Address - Street 2:
Practice Address - City:MIDDLE ISLAND
Practice Address - State:NY
Practice Address - Zip Code:11953-1440
Practice Address - Country:US
Practice Address - Phone:845-505-0120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-27
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY092893-011041C0700X
095460-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker