Provider Demographics
NPI:1164686416
Name:FARHAT, LISA GARRETT (MED, LPC, RPT)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:GARRETT
Last Name:FARHAT
Suffix:
Gender:F
Credentials:MED, LPC, RPT
Other - Prefix:MISS
Other - First Name:LISA
Other - Middle Name:REE
Other - Last Name:GARRETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC-1
Mailing Address - Street 1:103 ABBY LN
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-4713
Mailing Address - Country:US
Mailing Address - Phone:817-229-7900
Mailing Address - Fax:
Practice Address - Street 1:4150 INTERNATIONAL PLZ
Practice Address - Street 2:SUITE 600
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-4892
Practice Address - Country:US
Practice Address - Phone:817-229-7900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20098101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional