=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407364789
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SUE FARLEY, MA, LPC, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/19/2018
-----------------------------------------------------
Last Update Date | 12/27/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 114 S 2ND ST
-----------------------------------------------------
City | PHILLIPSBURG
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08865-1806
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-510-3118
-----------------------------------------------------
Fax | 908-290-5215
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 114 S 2ND ST
-----------------------------------------------------
City | PHILLIPSBURG
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08865-1806
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-510-3118
-----------------------------------------------------
Fax | 908-290-5215
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | SUE FARLEY
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 908-510-3118
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | 37PC00513800
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------