Austin Lee James Farris
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Vincent, OH
NPI 1649954033 · NPPES record last updated Jun 14, 2023
Key facts
- NPI
- 1649954033
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- CDCA.184481 (OH)
- Practice address
- 4945 State Route 339
Vincent, OH 45784-5106 - Phone
- (740) 993-0399
- NPI assigned
- Jun 14, 2023
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|
| CDCA.184481 | OH | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Angels Harbor | Current |
Accepting new patients |
Locations
4945 State Route 339
Vincent, OH 45784
Phone (740) 371-5091
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.184481 | OH | Yes |
Addresses
Primary practice location
4945 State Route 339
Vincent, OH 45784-5106
Mailing address
4945 State Route 339
Vincent, OH 45784-5106
Other providers in Vincent, OH
- Lloyd Dennis
- Jessica N Dennison
- Nicole Jane Dotson
- Megan L Dougherty
- Gabriel Duskey
- First Settlement Physical Therapy
- Derrick Fox
- Thomas Glazier
- Jennifer Goddard
- Lori Helgesen
All providers in Vincent, OH · Addiction (Substance Use Disorder) Counselor in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2023. 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.