Provider Demographics
NPI:1811884935
Name:FARRIS, KENYA AILISA (LPC)
Entity type:Individual
Prefix:
First Name:KENYA
Middle Name:AILISA
Last Name:FARRIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5729 LEBANON RD STE 144-306
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-7260
Mailing Address - Country:US
Mailing Address - Phone:469-956-9400
Mailing Address - Fax:
Practice Address - Street 1:13148 COWPER DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-6489
Practice Address - Country:US
Practice Address - Phone:469-946-9400
Practice Address - Fax:469-946-9455
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX94600101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health