Provider Demographics
NPI:1568945392
Name:FARWELL, CATHERINE AMELIA (PSYD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:AMELIA
Last Name:FARWELL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 COASTAL CT
Mailing Address - Street 2:
Mailing Address - City:STATHAM
Mailing Address - State:GA
Mailing Address - Zip Code:30666-2493
Mailing Address - Country:US
Mailing Address - Phone:310-926-8976
Mailing Address - Fax:
Practice Address - Street 1:240 OLD EPPS BRIDGE RD
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2858
Practice Address - Country:US
Practice Address - Phone:706-850-7041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-07
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37931103TC0700X
GA4808103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical