Provider Demographics
NPI:1760052005
Name:JENNIFER FARRELL PLLC.
Entity Type:Organization
Organization Name:JENNIFER FARRELL PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELING PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:937-765-0654
Mailing Address - Street 1:1114 N BLACK ACRE CT
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-4432
Mailing Address - Country:US
Mailing Address - Phone:937-765-0654
Mailing Address - Fax:
Practice Address - Street 1:1073 WILLA SPRINGS DR STE 2013
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-6625
Practice Address - Country:US
Practice Address - Phone:407-753-7473
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-29
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty