Provider Demographics
NPI:1053933929
Name:FARR, NATALIAMARIE (MA, LPC)
Entity type:Individual
Prefix:
First Name:NATALIAMARIE
Middle Name:
Last Name:FARR
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4217 SWISS AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-6611
Mailing Address - Country:US
Mailing Address - Phone:469-222-3261
Mailing Address - Fax:
Practice Address - Street 1:ASCEND BEHAVIORAL HEALTH SERVICES 495 SPUR 156
Practice Address - Street 2:
Practice Address - City:WASKOM,
Practice Address - State:TX
Practice Address - Zip Code:75692-7520
Practice Address - Country:US
Practice Address - Phone:469-222-3261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79023101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional