Active NPI
Shawna Annie Michelle Farrar, LPCA
- Counselor
- Fort Worth, TX
National Provider Identifier
1396573325
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 95460
- Practice address
- 6012 Reef Point LN Ste C
Fort Worth, TX 76135-2056 - Phone
- (918) 782-8164
- NPI assigned
- Jul 22, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 95460 | TX | Primary |
Addresses
Primary practice location
6012 Reef Point LN Ste C
Fort Worth, TX 76135-2056
Mailing address
812 Ironsides LN
Blue Mound, TX 76131-1532
Phone (918) 782-8164
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 |
|---|---|---|---|
| 95460 | TX | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723766400000",
"number": "1396573325",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "812 IRONSIDES LN",
"city": "BLUE MOUND",
"state": "TX",
"postal_code": "761311532",
"telephone_number": "918-782-8164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6012 REEF POINT LN STE C",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761352056",
"telephone_number": "918-782-8164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARRAR",
"first_name": "SHAWNA",
"middle_name": "ANNIE MICHELLE",
"credential": "LPCA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-22",
"last_updated": "2024-08-16",
"certification_date": "2024-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "95460",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.