Individual provider Active NPI

Suzan Marie Farr

  • Counselor
  • Coburg, OR
National Provider Identifier
1629619267
Registry record updated Oct 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
91150 Coburg Industrial Lane
Coburg, OR 97408
Phone
(416) 871-1105
Fax
(541) 735-6572
NPI assigned
Oct 4, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X OR Primary

Addresses

Primary practice location

91150 Coburg Industrial Lane
Coburg, OR 97408

Mailing address

91150 Coburg Industrial Lane
Coburg, OR 97408
Phone (416) 871-1105

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL sfarr@serenitylane.org Direct

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

NPI Registry JSON

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

{
    "created_epoch": "1570147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1629619267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91150 COBURG INDUSTRIAL LANE",
            "city": "COBURG",
            "state": "OR",
            "postal_code": "97408",
            "telephone_number": "416-871-1105",
            "fax_number": "541-735-6572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91150 COBURG INDUSTRIAL LANE",
            "city": "COBURG",
            "state": "OR",
            "postal_code": "97408",
            "telephone_number": "416-871-1105",
            "fax_number": "541-735-6572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARR",
        "first_name": "SUZAN",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-04",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "sfarr@serenitylane.org",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "91150 Coburg Industrial Way",
            "city": "Coburg",
            "state": "OR",
            "country_code": "US",
            "postal_code": "97408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.

Verify at the official NPI Registry.