Active NPI
Angela Marie Farley, LLMSW
- Behavior Analyst
- Detroit, MI
National Provider Identifier
1265749279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 11520671
- Practice address
- 79 W Alexandrine St
Detroit, MI 48201-2015 - Phone
- (313) 831-5535
- Fax
- (313) 831-2608
- NPI assigned
- Sep 13, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801094294 | MI | |
| Behavior Analyst | 103K00000X | 11520671 | MI | Primary |
Addresses
Primary practice location
79 W Alexandrine St
Detroit, MI 48201-2015
Mailing address
79 W Alexandrine St
Detroit, MI 48201-2015
Phone (313) 324-8585
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11520671 | MI | MD | Behavioral Analyst |
| 6801094294 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562112000000",
"number": "1265749279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "79 W ALEXANDRINE ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012015",
"telephone_number": "313-324-8585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "79 W ALEXANDRINE ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012015",
"telephone_number": "313-831-5535",
"fax_number": "313-831-2608"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARLEY",
"first_name": "ANGELA",
"middle_name": "MARIE",
"credential": "LLMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-13",
"last_updated": "2019-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801094294",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MI",
"license": "11520671",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.