Sandra Marie Farley, M.S., LPC, AADC

Key facts

NPI

1104986389

Entity type

Individual (NPI type 1)

Primary specialty

Mental Health Counselor 101YM0800X

License

5190 (NC)

Practice address

1125 Route 65
Delbarton, WV 25670-7234

Phone

(980) 825-9878

NPI assigned

Dec 11, 2006

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Master of Science

State licenses

Specialties & licenses

Addresses

Other identifiers

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 30, 2021.

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1104986389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 ROUTE 65",
            "city": "DELBARTON",
            "state": "WV",
            "postal_code": "256707234",
            "telephone_number": "980-825-9878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 ROUTE 65",
            "city": "DELBARTON",
            "state": "WV",
            "postal_code": "256707234",
            "telephone_number": "980-825-9878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARLEY",
        "first_name": "SANDRA",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "M.S., LPC, AADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "5190",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1165",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6103493",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sandra@supervisionbysandra.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1125 Route 65",
            "city": "Delbarton",
            "state": "WV",
            "country_code": "US",
            "postal_code": "256707234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Delbarton, WV

• Jocelyn Patricia Ellis
• Bobby Rhodes Evans
• Queona Sharii Evans
• Shelia Renea Evans
• Glenna Farley
• Alexandra Marie Fields
• Monroe Gibson
• Haley Gillman
• Gloria Goble
• Jennifer Gollihue

All providers in Delbarton, WV · Mental Health Counselor in West Virginia