Provider Demographics
NPI:1730101080
Name:FARNSWORTH, FRAN (LICSW)
Entity Type:Individual
Prefix:
First Name:FRAN
Middle Name:
Last Name:FARNSWORTH
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:FRAN
Other - Middle Name:
Other - Last Name:GUTTMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:11 BAY STATE CT
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:MA
Mailing Address - Zip Code:02631-2120
Mailing Address - Country:US
Mailing Address - Phone:617-847-1950
Mailing Address - Fax:617-774-1490
Practice Address - Street 1:11 BAY STATE CT
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:MA
Practice Address - Zip Code:02631-2120
Practice Address - Country:US
Practice Address - Phone:617-847-1950
Practice Address - Fax:617-774-1490
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10167021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
334626OtherMHN/TRICARE
MAP04884OtherBLUE CROSS
MAP04884Medicare ID - Type Unspecified