Individual provider Active NPI

James G Farnham, MA, LICSW

  • Clinical Social Worker
  • Walpole, MA
National Provider Identifier
1386662997
Registry record updated Dec 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
114117 Issued in MA
Practice address
Colony Care Behavioral Health
841 Main Street
Walpole, MA 02081
Phone
(508) 404-3334
Fax
(508) 660-6658
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 004967 CT
Clinical Social Worker 1041C0700X 114117 MA Primary

Addresses

Primary practice location

Colony Care Behavioral Health
841 Main Street
Walpole, MA 02081

Mailing address

Colony Care Behavioral Health
841 Main Street
Walpole, MA 02081
Phone (508) 404-3334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090909000082 MA Practitioner - Clinical Social Worker 5991707465 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
114117MAMDClinical Social Worker
004967CTMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Walpole Behavioral Healthcare, LLC Clinical CurrentSince May 30, 2017 Accepting new patients
Colony Care Inc Past Accepting new patients

Locations

841 Main St
Walpole, MA 02081
Phone (508) 660-2900

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197936000000",
    "number": "1386662997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "COLONY CARE BEHAVIORAL HEALTH",
            "address_2": "841 MAIN STREET",
            "city": "WALPOLE",
            "state": "MA",
            "postal_code": "02081",
            "telephone_number": "508-404-3334",
            "fax_number": "508-660-6658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "COLONY CARE BEHAVIORAL HEALTH",
            "address_2": "841 MAIN STREET",
            "city": "WALPOLE",
            "state": "MA",
            "postal_code": "02081",
            "telephone_number": "508-404-3334",
            "fax_number": "508-660-6658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARNHAM",
        "first_name": "JAMES",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "MA, LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004967",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "114117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walpole, MA

Sources for this page

Verify at the official NPI Registry.