Provider Demographics
NPI:1629657721
Name:FARRIS, CHLOE ANNE (LCSW)
Entity Type:Individual
Prefix:
First Name:CHLOE
Middle Name:ANNE
Last Name:FARRIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:CHLOE
Other - Middle Name:ANNE
Other - Last Name:FARRIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 224624
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00822-4624
Mailing Address - Country:US
Mailing Address - Phone:340-227-8659
Mailing Address - Fax:
Practice Address - Street 1:5030 ANCHOR WAY STE 9&10
Practice Address - Street 2:
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820-4692
Practice Address - Country:US
Practice Address - Phone:340-227-8659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI2-52436-1B1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical