Provider Demographics
NPI:1811280761
Name:FARERO, ADAM M (LMFT)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:M
Last Name:FARERO
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:863 EATON DR
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:MI
Mailing Address - Zip Code:48854-1335
Mailing Address - Country:US
Mailing Address - Phone:517-258-2486
Mailing Address - Fax:
Practice Address - Street 1:863 EATON DR
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:MI
Practice Address - Zip Code:48854-1335
Practice Address - Country:US
Practice Address - Phone:517-258-2486
Practice Address - Fax:517-306-4821
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-25
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI4101007114106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty