Provider Demographics
NPI:1770292906
Name:ZAINUDDIN, FARIAH (MS, NCC, LPC-A)
Entity type:Individual
Prefix:
First Name:FARIAH
Middle Name:
Last Name:ZAINUDDIN
Suffix:
Gender:F
Credentials:MS, NCC, LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 CLUB DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60139-3678
Mailing Address - Country:US
Mailing Address - Phone:210-488-0398
Mailing Address - Fax:
Practice Address - Street 1:4115 ESTERS RD APT 702
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-4721
Practice Address - Country:US
Practice Address - Phone:210-488-0398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87113101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health