Provider Demographics
NPI:1356479109
Name:FARRO, THERESA MARIE (CAP, LMHC)
Entity type:Individual
Prefix:MISS
First Name:THERESA
Middle Name:MARIE
Last Name:FARRO
Suffix:
Gender:F
Credentials:CAP, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7410 S US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-1432
Mailing Address - Country:US
Mailing Address - Phone:772-340-5044
Mailing Address - Fax:772-340-5916
Practice Address - Street 1:7410 S US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-1432
Practice Address - Country:US
Practice Address - Phone:772-340-5044
Practice Address - Fax:772-340-5916
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)