Provider Demographics
NPI:1730252776
Name:LOBENSTINE, FARNSWORTH (LICSW)
Entity type:Individual
Prefix:
First Name:FARNSWORTH
Middle Name:
Last Name:LOBENSTINE
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 DEWEY CT # 1
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3816
Mailing Address - Country:US
Mailing Address - Phone:413-256-3637
Mailing Address - Fax:413-253-6389
Practice Address - Street 1:16 CENTER ST STE 423
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3031
Practice Address - Country:US
Practice Address - Phone:413-256-3637
Practice Address - Fax:413-253-6389
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10290561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000027052Medicaid
MA113850OtherVALUE OPTIONS
MAP2577163OtherOXFORD HEALTH
MA1858513Medicaid
MA265439000OtherMAGELLAN
MAP07743OtherBCBS
MA454726OtherTUFTS
MA115064OtherTEAMSTERS