Provider Demographics
NPI:1922190164
Name:FARKAS, JILL J (CRCCASAC LMHC)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:J
Last Name:FARKAS
Suffix:
Gender:F
Credentials:CRCCASAC LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 HARVARD ST
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-2901
Mailing Address - Country:US
Mailing Address - Phone:718-849-6300
Mailing Address - Fax:718-849-9654
Practice Address - Street 1:11711 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-1751
Practice Address - Country:US
Practice Address - Phone:718-849-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7674101YA0400X
NY2399101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health