Provider Demographics
NPI:1538606629
Name:FARNHAM, TARRA (MA, LCMHC)
Entity type:Individual
Prefix:
First Name:TARRA
Middle Name:
Last Name:FARNHAM
Suffix:
Gender:F
Credentials:MA, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 TAMIAMI TRL STE J-1005
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33948-1077
Mailing Address - Country:US
Mailing Address - Phone:910-849-9762
Mailing Address - Fax:
Practice Address - Street 1:3527 TAMIAMI TRL STE E
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-8128
Practice Address - Country:US
Practice Address - Phone:103-198-8749
Practice Address - Fax:239-932-7252
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-26
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health