Provider Demographics
NPI:1609046507
Name:DARYA, FERESHTEH HAERI (PHD, LCPC)
Entity Type:Individual
Prefix:DR
First Name:FERESHTEH
Middle Name:HAERI
Last Name:DARYA
Suffix:
Gender:F
Credentials:PHD, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 8TH AVE W STE 200
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-5162
Mailing Address - Country:US
Mailing Address - Phone:301-806-6948
Mailing Address - Fax:240-390-2400
Practice Address - Street 1:600 8TH AVE W STE 200
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221-5162
Practice Address - Country:US
Practice Address - Phone:301-806-6948
Practice Address - Fax:240-390-2400
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-06
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2795101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD019149300Medicaid