Healthcare Provider Details

I. General information

NPI: 1427561232
Provider Name (Legal Business Name): KOVACS-FARKAS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2017
Last Update Date: 11/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 HIGHLAND AVE STE C
HADDON TOWNSHIP NJ
08108-2634
US

IV. Provider business mailing address

13 FORGE LN
CHERRY HILL NJ
08002-1665
US

V. Phone/Fax

Practice location:
  • Phone: 856-854-3155
  • Fax:
Mailing address:
  • Phone: 856-667-7552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number35S100580500
License Number StateNJ

VIII. Authorized Official

Name: DR. LISA J FARKAS
Title or Position: OWNER
Credential: PSY.D.
Phone: 856-854-3155