Provider Demographics
NPI:1063842136
Name:FARIN, MARK (MS, LPC)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:FARIN
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 OLD WEST CHESTER PIKE
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-2712
Mailing Address - Country:US
Mailing Address - Phone:484-454-8700
Mailing Address - Fax:484-454-8706
Practice Address - Street 1:2000 OLD WEST CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-2712
Practice Address - Country:US
Practice Address - Phone:484-454-8700
Practice Address - Fax:484-454-8706
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-26
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007187101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health