Provider Demographics
NPI:1619188679
Name:FARRELL, LINDA CHRISTINE (MED NCC)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:CHRISTINE
Last Name:FARRELL
Suffix:
Gender:F
Credentials:MED NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 PAUL PL
Mailing Address - Street 2:
Mailing Address - City:HASKELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07420-1049
Mailing Address - Country:US
Mailing Address - Phone:973-632-4739
Mailing Address - Fax:
Practice Address - Street 1:16 POMPTON AVE
Practice Address - Street 2:
Practice Address - City:POMPTON LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07442-1895
Practice Address - Country:US
Practice Address - Phone:973-835-6337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ203557101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor