Provider Demographics
NPI:1427667476
Name:FARNSWORTH, BRIANNA (PLPC)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:FARNSWORTH
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 FAIRMONT AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-2710
Mailing Address - Country:US
Mailing Address - Phone:304-641-1104
Mailing Address - Fax:681-404-6871
Practice Address - Street 1:207 FAIRMONT AVE
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-0168
Practice Address - Country:US
Practice Address - Phone:681-404-6869
Practice Address - Fax:681-404-6871
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV870101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional