Provider Demographics
NPI:1932865557
Name:FARKAS, CRYSTAL M (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:M
Last Name:FARKAS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 SPARTA AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-1760
Mailing Address - Country:US
Mailing Address - Phone:862-200-3780
Mailing Address - Fax:973-726-0710
Practice Address - Street 1:300 FOREST AVE
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-5429
Practice Address - Country:US
Practice Address - Phone:201-490-5158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-09
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC060307001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ44SC06030700OtherBOARD OF SOCIAL WORK EXAMINERS