Marissa Ethridge Farquhar, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

M9392 Issued in MS

Practice address

4735 Old Canton Rd Ste 111
Jackson, MS 39211-5500

Phone

(601) 479-3397

NPI assigned

Jul 18, 2023

Last updated

Jul 18, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1144909961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 SUMMIT RIDGE DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390422503",
            "telephone_number": "601-479-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 OLD CANTON RD STE 111",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115500",
            "telephone_number": "601-479-3397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARQUHAR",
        "first_name": "MARISSA",
        "middle_name": "ETHRIDGE",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "M9392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myles Darian Faries, OT
• Edward P Farley, M.D.
• Farmer and Associates Internal Medicine
• Lashondra J Farmer-Whitlock, NP
• Kelley Jo Farner, NP
• Coleman Farr, NP-C
• John Farr, PMHNP-BC
• Andrea Farrar, LSW
• Kathryn R Farrell, MD
• Starke R Farrell, LCSW

• Clinical Social Worker in Jackson, MS
• Providers in Jackson, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.