Provider Demographics
NPI:1366153561
Name:FARMER, CYNTHIA SPARTA (LCMHCA)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:SPARTA
Last Name:FARMER
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 HOLDING YOUNG RD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27596-9254
Mailing Address - Country:US
Mailing Address - Phone:919-257-9416
Mailing Address - Fax:
Practice Address - Street 1:45 HOLDING YOUNG RD
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27596-9254
Practice Address - Country:US
Practice Address - Phone:919-257-9416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-08
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
A18338101YP2500X
NCA18338101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional