Kelly Marie Farmer, LPC
Individual provider Active NPI Counselor · Manhattan, IL
NPI 1649067117 · NPPES record last updated Apr 21, 2025
Key facts
- NPI
- 1649067117
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 178.020683 (IL)
- Practice address
- 29254 S Wallingford Rd
Manhattan, IL 60442-9693 - Phone
- (708) 825-8512
- NPI assigned
- Apr 21, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178.020683 | IL | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 178.020683 | IL | Yes |
Addresses
Primary practice location
29254 S Wallingford Rd
Manhattan, IL 60442-9693
Mailing address
14933 Founders Xing
Homer Glen, IL 60491-6712
Phone (708) 737-7968
Other providers in Manhattan, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.