Provider Demographics
NPI:1538849658
Name:FARABAUGH, MICHELE (LCSW)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:FARABAUGH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3526 BAKERSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:BAKERSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15007-9705
Mailing Address - Country:US
Mailing Address - Phone:724-953-6402
Mailing Address - Fax:
Practice Address - Street 1:3526 BAKERSTOWN RD
Practice Address - Street 2:
Practice Address - City:BAKERSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15007-9705
Practice Address - Country:US
Practice Address - Phone:724-953-6402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0144501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical