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Individual

STARKE R FARRELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
248 E CAPITOL ST, 840 TRUST MARK BLDG, JACKSON, MS 39201-2503
(800) 632-6074
Mailing address
118 N COMMERCE ST, PO BOX 726, RIPLEY, MS 38663-2009
(662) 993-9024
(662) 993-9025

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C6287
MS

Other

Enumeration date
08/13/2006
Last updated
07/08/2007
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