Provider Demographics
NPI:1184929473
Name:FARRELL-CARNAHAN, LEAH VARNEY (PHD)
Entity type:Individual
Prefix:DR
First Name:LEAH
Middle Name:VARNEY
Last Name:FARRELL-CARNAHAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:834 INMAN VILLAGE PKWY NE STE 220
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30307-5502
Mailing Address - Country:US
Mailing Address - Phone:404-710-6605
Mailing Address - Fax:
Practice Address - Street 1:834 INMAN VILLAGE PKWY NE STE 220
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30307-5502
Practice Address - Country:US
Practice Address - Phone:404-710-6605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-18
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004370103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical