Jody Dean Farra, MA LPE LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC000282 Issued in TN

Practice address

6 Sixth St
Central Building Suite 205
Bristol, TN 37620

Phone

(423) 968-2225

Fax

(423) 968-2225

NPI assigned

Aug 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285641340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1242 HIGHRIDGE DRIVE",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "37664",
            "telephone_number": "423-323-9289",
            "fax_number": "423-968-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 SIXTH ST",
            "address_2": "CENTRAL BUILDING SUITE 205",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "37620",
            "telephone_number": "423-968-2225",
            "fax_number": "423-968-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRA",
        "first_name": "JODY",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "MA LPE LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "PE000531",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "LPC000282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FED GOVT TRADE PARTNER ID",
            "identifier": "TPIN 13037341",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Bristol, TN
• Providers in Bristol, TN by specialty
• Mental Health Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.