Provider Demographics
NPI:1689056863
Name:FARRAR, TWILA MICHELLE (MED, LPC-S, RPT-S)
Entity type:Individual
Prefix:
First Name:TWILA
Middle Name:MICHELLE
Last Name:FARRAR
Suffix:
Gender:
Credentials:MED, LPC-S, RPT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5728 LYNDON B. JOHNSON FWY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240
Mailing Address - Country:US
Mailing Address - Phone:972-825-6570
Mailing Address - Fax:
Practice Address - Street 1:5728 LYNDON B JOHNSON FWY STE 250
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6323
Practice Address - Country:US
Practice Address - Phone:972-825-6570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-24
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK12104101YM0800X
TX70471101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional