Provider Demographics
NPI:1104628213
Name:FARRIS, ABIGAIL MARIE (LGSW)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:MARIE
Last Name:FARRIS
Suffix:
Gender:
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3923 BEAR MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-8008
Mailing Address - Country:US
Mailing Address - Phone:304-931-6176
Mailing Address - Fax:
Practice Address - Street 1:3602 COLLINS FERRY RD
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-2378
Practice Address - Country:US
Practice Address - Phone:304-598-4214
Practice Address - Fax:304-598-6383
Is Sole Proprietor?:No
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVBP009471521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical