Provider Demographics
NPI:1366515413
Name:FARM, JAMES MICHAEL (LMFT)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:MICHAEL
Last Name:FARM
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
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Mailing Address - Street 1:2115 COUNTY ROAD D E
Mailing Address - Street 2:SUITE B
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-5353
Mailing Address - Country:US
Mailing Address - Phone:651-748-5019
Mailing Address - Fax:651-773-7591
Practice Address - Street 1:2006 1ST AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:ANOKA
Practice Address - State:MN
Practice Address - Zip Code:55303-2290
Practice Address - Country:US
Practice Address - Phone:763-421-5535
Practice Address - Fax:763-433-0226
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN1495106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP67672OtherHEALTH PARTNERS
MN79G22FAOtherBLUE CROSS BLUE SHIELD