Provider Demographics
NPI:1750067963
Name:FARRAR, YOLONDA SUE (LMLP, LCAC)
Entity type:Individual
Prefix:DR
First Name:YOLONDA
Middle Name:SUE
Last Name:FARRAR
Suffix:
Gender:F
Credentials:LMLP, LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1214 WAVERLY ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-3530
Mailing Address - Country:US
Mailing Address - Phone:316-737-5216
Mailing Address - Fax:
Practice Address - Street 1:560 N EXPOSITION ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-5902
Practice Address - Country:US
Practice Address - Phone:316-251-9600
Practice Address - Fax:316-251-6981
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS00765103TA0400X
KS03165103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)