Shelly Jean Farnan, PSYD., LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2009030819 Issued in MO

Practice address

1300 E Bradford Pkwy
Springfield, MO 65804

Phone

(417) 761-5000

Fax

(417) 761-5011

NPI assigned

Oct 12, 2009

Last updated

Jan 25, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• AIDS Project of the Ozarks

  dba APO Pharmacy

  • Community/Retail Pharmacy
  • Springfield, MO
  • NPI 1194277681
  NPD (past)
• New Beginnings Behavioral Health

  • Clinical Psychologist
  • Nixa, MO
  • NPI 1285810432
  NPD (past)

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

{
    "created_epoch": "1255305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1962737734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 E BRADFORD PKWY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044264",
            "telephone_number": "417-761-5000",
            "fax_number": "417-761-5065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 E BRADFORD PKWY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "65804",
            "telephone_number": "417-761-5000",
            "fax_number": "417-761-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARNAN",
        "first_name": "SHELLY",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "PSYD., LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-12",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2009030819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "499446706",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tasnuva Tarannum Fariza, MD
• Alicia L Farley, PA
• Walter Joe Farley, M.D.
• Andrew Charles Farmer, LPC
• Sarah Farmer
• Margaret Farquhar, RN
• Elizabeth Ann Farrah, LCSW
• Brigid Farrar, PHARMD, MHA, AAHIVP
• Andrew Farrell
• Barbara Manzer Farrell, PSYD, LP

• Clinical Psychologist in Springfield, MO
• Providers in Springfield, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.

Verify at the official NPI Registry.