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Individual

PENNY FARRIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
1721 E OSAGE RD STE 100, DERBY, KS 67037-2198
(910) 975-6648
(316) 252-1336
Mailing address
1721 E OSAGE RD, SUITE 100, DERBY, KS 67037-9158
(910) 975-6648
(316) 252-1336

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
04203
KS
101YM0800X
Mental Health Counselor
A17448
NC
101YP2500X
Professional Counselor
Primary
04158
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30004869770001
KS
05
30004869770002
KS
Enumeration date
03/28/2022
Last updated
03/24/2026
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