Provider Demographics
NPI:1982975702
Name:DAVIS, FARAH LINDLEY (P-LCSW)
Entity Type:Individual
Prefix:MISS
First Name:FARAH
Middle Name:LINDLEY
Last Name:DAVIS
Suffix:
Gender:F
Credentials:P-LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399B OLD BLACK CREEK RD
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NC
Mailing Address - Zip Code:27830-9448
Mailing Address - Country:US
Mailing Address - Phone:919-215-0987
Mailing Address - Fax:
Practice Address - Street 1:300 VEAZEY DR
Practice Address - Street 2:
Practice Address - City:BUTNER
Practice Address - State:NC
Practice Address - Zip Code:27509-1668
Practice Address - Country:US
Practice Address - Phone:919-764-5213
Practice Address - Fax:919-764-5231
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0062571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical