Provider Demographics
NPI:1598709743
Name:FARR, DONALD DEVERE (LCSW,CSOTP)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:DEVERE
Last Name:FARR
Suffix:
Gender:M
Credentials:LCSW,CSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13113 BLUEMONT RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-4621
Mailing Address - Country:US
Mailing Address - Phone:804-796-7887
Mailing Address - Fax:804-796-9667
Practice Address - Street 1:211 N. 5TH AVE
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:VA
Practice Address - Zip Code:23860-2712
Practice Address - Country:US
Practice Address - Phone:804-536-1543
Practice Address - Fax:804-796-9667
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040014711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA8921539Medicaid
VAR60621Medicare UPIN
VA800002483Medicare ID - Type Unspecified