Jody Dean Farra, MA LPE LPC
Counselor, Mental Health in Bristol, TN. Individual provider (NPI-1).
NPI number1285641340
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1285641340
- Entity type
- Individual (NPI-1)
- Name
- Mr. Jody Dean Farra
- Credential
- MA LPE LPC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 2, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | LPC000282 | TN | Yes |
| 101YM0800X | Counselor, Mental Health | PE000531 | TN |
Practice location
6 Sixth StCentral Building Suite 205
Bristol, TN 37620
Phone 423-968-2225 · Fax 423-968-2225
Mailing address
1242 Highridge DriveKingsport, TN 37664
Phone 423-323-9289 · Fax 423-968-2225
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