| Doctor Name: | NICOLE FARRIS |
| NPI Number: | 1023246766 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS/EDS, LCPC, NCC |
| License Number: | LC3320 |
| Business Practice Address: | 18221-d Flower Hill Way Gaithersburg, MD - 208795333 |
| Business Phone Number: | 3012198559 |
| Business Fax Number: | |
| Mailing Address: | 12301 Silvergate Way # 906e, GERMANTOWN |
| State: | MD |
| Postal Code: | 208742548 |
| Phone Number: | 3012198559 |
| Fax Number: | 3017312082 |
| NPI Enumeration Date: | 07/01/2009 |
| NPI Last Update Date: | 02/08/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LC3320 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |