Provider Demographics
NPI:1164119624
Name:FARRELL, LAMAR MARLON
Entity Type:Individual
Prefix:
First Name:LAMAR
Middle Name:MARLON
Last Name:FARRELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:383 E 17TH ST APT 2C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-5744
Mailing Address - Country:US
Mailing Address - Phone:347-760-5024
Mailing Address - Fax:
Practice Address - Street 1:347 5TH AVE RM 1402
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5034
Practice Address - Country:US
Practice Address - Phone:347-460-6570
Practice Address - Fax:347-329-4333
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health