Provider Demographics
NPI:1952875916
Name:FARROW, T NICOLE (MS, ED S, NCC, LPC)
Entity Type:Individual
Prefix:
First Name:T NICOLE
Middle Name:
Last Name:FARROW
Suffix:
Gender:F
Credentials:MS, ED S, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BUCKDEN LN
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72715-2402
Mailing Address - Country:US
Mailing Address - Phone:417-268-8086
Mailing Address - Fax:
Practice Address - Street 1:1200 W WALNUT ST STE 1400J
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-3521
Practice Address - Country:US
Practice Address - Phone:417-268-8086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-13
Last Update Date:2019-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1811146101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor