Provider Demographics
NPI:1700326121
Name:LEDEE-FARLEY, IRENE (LMSW, LSW)
Entity Type:Individual
Prefix:MS
First Name:IRENE
Middle Name:
Last Name:LEDEE-FARLEY
Suffix:
Gender:F
Credentials:LMSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 COURT ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11242-0103
Mailing Address - Country:US
Mailing Address - Phone:917-974-7259
Mailing Address - Fax:
Practice Address - Street 1:26 COURT ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11242-0103
Practice Address - Country:US
Practice Address - Phone:917-974-7259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-03
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY080986101Y00000X
NJ44SL05899700101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor