Provider Demographics
NPI:1770855041
Name:PAMELA FARRELL LCSW PSYCHOTHERAPY LLC
Entity Type:Organization
Organization Name:PAMELA FARRELL LCSW PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:908-246-1448
Mailing Address - Street 1:62 CHERRYVILLE HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-5528
Mailing Address - Country:US
Mailing Address - Phone:908-246-1448
Mailing Address - Fax:866-936-6552
Practice Address - Street 1:62 CHERRYVILLE HOLLOW RD
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-5528
Practice Address - Country:US
Practice Address - Phone:908-246-1448
Practice Address - Fax:866-936-6552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-02
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053386001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty