Provider Demographics
NPI:1104238195
Name:BENJAMIN FARMER LMFT LLC
Entity type:Organization
Organization Name:BENJAMIN FARMER LMFT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:K
Authorized Official - Last Name:FARMER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMFT
Authorized Official - Phone:435-881-1107
Mailing Address - Street 1:2078 ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-5506
Mailing Address - Country:US
Mailing Address - Phone:435-881-1107
Mailing Address - Fax:
Practice Address - Street 1:650 S KOMAS DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84108-1215
Practice Address - Country:US
Practice Address - Phone:435-881-1107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-23
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7551881-3902251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health