Provider Demographics
NPI:1356552483
Name:FARREY, SHARON M (LCSW)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:M
Last Name:FARREY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:273 CROSS ST
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:WI
Mailing Address - Zip Code:53803-8917
Mailing Address - Country:US
Mailing Address - Phone:608-759-9930
Mailing Address - Fax:608-348-9650
Practice Address - Street 1:N3152 STATE ROAD 81
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WI
Practice Address - Zip Code:53566-9397
Practice Address - Country:US
Practice Address - Phone:608-328-9388
Practice Address - Fax:608-328-9650
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6992-123102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst