Provider Demographics
NPI:1679245849
Name:WILLIAMS-FARRAR, CHARMAIN V (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:CHARMAIN
Middle Name:V
Last Name:WILLIAMS-FARRAR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1607 ROUTE 300 STE 101
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-1738
Mailing Address - Country:US
Mailing Address - Phone:646-255-4114
Mailing Address - Fax:
Practice Address - Street 1:80 MAYBROOK RD
Practice Address - Street 2:
Practice Address - City:CAMPBELL HALL
Practice Address - State:NY
Practice Address - Zip Code:10916-2713
Practice Address - Country:US
Practice Address - Phone:646-255-4114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY114100-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical