Individual
FARAH SOUTHWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC, CPCS
Contact information
Practice address
1725 PENNSYLVANIA AVE, MCDONOUGH, GA 30253-9118
(678) 853-5849
Mailing address
1725 PENNSYLVANIA AVE, MCDONOUGH, GA 30253-9118
(678) 853-5849
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC010787
GA
101YM0800X
Mental Health Counselor
MH5568
FL
Other
Enumeration date
03/11/2008
Last updated
10/03/2023
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