Healthcare Provider Details

I. General information

NPI: 1760819932
Provider Name (Legal Business Name): FARAH N SKOW LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2013
Last Update Date: 11/03/2022
Certification Date: 11/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 CORBETT WAY STE 304
EATONTOWN NJ
07724-4261
US

IV. Provider business mailing address

99 CORBETT WAY STE 304
EATONTOWN NJ
07724-4261
US

V. Phone/Fax

Practice location:
  • Phone: 732-443-0530
  • Fax:
Mailing address:
  • Phone: 732-443-0530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37PC00555000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: