Provider Demographics
NPI:1558747568
Name:FARNSWORTH, KARLENE (LCMHC LADC)
Entity type:Individual
Prefix:
First Name:KARLENE
Middle Name:
Last Name:FARNSWORTH
Suffix:
Gender:F
Credentials:LCMHC LADC
Other - Prefix:
Other - First Name:KARLENE
Other - Middle Name:
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:338 HIGHLAND AVE APT 103
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:VT
Mailing Address - Zip Code:05855-4866
Mailing Address - Country:US
Mailing Address - Phone:802-673-7883
Mailing Address - Fax:
Practice Address - Street 1:338 HIGHLAND AVE APT 103
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:VT
Practice Address - Zip Code:05855-4866
Practice Address - Country:US
Practice Address - Phone:802-673-7883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-03
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT000533101YA0400X
VT068.0098893101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)