Provider Demographics
NPI:1780963512
Name:FARNUM, EMILY B (LCSW)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:B
Last Name:FARNUM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 LOCUST AVE
Mailing Address - Street 2:SUITE 1D
Mailing Address - City:NEW CANAAN
Mailing Address - State:CT
Mailing Address - Zip Code:06840-4735
Mailing Address - Country:US
Mailing Address - Phone:203-308-3187
Mailing Address - Fax:
Practice Address - Street 1:21 LOCUST AVE
Practice Address - Street 2:SUITE 1D
Practice Address - City:NEW CANAAN
Practice Address - State:CT
Practice Address - Zip Code:06840-4735
Practice Address - Country:US
Practice Address - Phone:203-308-3187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-10
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0077061041C0700X
NY0800801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical