Provider Demographics
NPI:1942598255
Name:FARMER, DANIEL (MS, LCAS, CRC, CCJP)
Entity Type:Individual
Prefix:MS
First Name:DANIEL
Middle Name:
Last Name:FARMER
Suffix:
Gender:F
Credentials:MS, LCAS, CRC, CCJP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-9728
Mailing Address - Country:US
Mailing Address - Phone:252-531-6852
Mailing Address - Fax:
Practice Address - Street 1:209 FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-9728
Practice Address - Country:US
Practice Address - Phone:252-531-6852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1704101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)