Provider Demographics
NPI:1740657980
Name:FARKAS, NICHOLAS (LMHC)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:FARKAS
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2108 SW 152ND ST STE E
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-2069
Mailing Address - Country:US
Mailing Address - Phone:860-480-6161
Mailing Address - Fax:
Practice Address - Street 1:2108 SW 152ND ST STE E
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-2069
Practice Address - Country:US
Practice Address - Phone:253-260-3557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-24
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO 60604805390200000X
390200000X
WACG 60642539101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program