Provider Demographics
NPI:1871545343
Name:FARRIS, DANIEL E SR (LPC)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:E
Last Name:FARRIS
Suffix:SR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 RIVER RUN
Mailing Address - Street 2:305
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-6579
Mailing Address - Country:US
Mailing Address - Phone:972-333-0960
Mailing Address - Fax:
Practice Address - Street 1:1701 RIVER RUN
Practice Address - Street 2:305
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-6579
Practice Address - Country:US
Practice Address - Phone:972-333-0960
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13518101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional