Provider Demographics
NPI:1528020161
Name:FARNEY, SARAH KIDD (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:KIDD
Last Name:FARNEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ELLIS ST
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:NY
Mailing Address - Zip Code:14564-1343
Mailing Address - Country:US
Mailing Address - Phone:585-924-7354
Mailing Address - Fax:
Practice Address - Street 1:6800 PITTSFORD PALMYRA RD
Practice Address - Street 2:SUITE 135
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450-3584
Practice Address - Country:US
Practice Address - Phone:585-678-4444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014376103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical