Provider Demographics
NPI:1588986764
Name:FARWELL ASSOCIATES
Entity type:Organization
Organization Name:FARWELL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIETTE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HANLON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:207-353-8118
Mailing Address - Street 1:22 FARWELL ST
Mailing Address - Street 2:
Mailing Address - City:LISBON
Mailing Address - State:ME
Mailing Address - Zip Code:04250-6824
Mailing Address - Country:US
Mailing Address - Phone:207-353-8118
Mailing Address - Fax:207-407-1209
Practice Address - Street 1:22 FARWELL ST
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:ME
Practice Address - Zip Code:04250-6824
Practice Address - Country:US
Practice Address - Phone:207-353-8118
Practice Address - Fax:207-407-1209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-16
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME593865251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1932274859OtherENTITY TYPE 1 NPI NUMBER