Provider Demographics
NPI:1598444747
Name:FARLEY, COLLEEN (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:FARLEY
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 ATLANTIC AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01952-2831
Mailing Address - Country:US
Mailing Address - Phone:978-604-9750
Mailing Address - Fax:
Practice Address - Street 1:131 ATLANTIC AVE APT 8
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MA
Practice Address - Zip Code:01952-2831
Practice Address - Country:US
Practice Address - Phone:978-604-9750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-14
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2023063503363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health