Basic Information
| Provider Information | |||||||||
| NPI: | 1427561232 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KOVACS-FARKAS COUNSELING LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13 FORGE LN | ||||||||
| Address2: | |||||||||
| City: | CHERRY HILL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080021665 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8566677552 | ||||||||
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| Practice Location | |||||||||
| Address1: | 215 HIGHLAND AVE STE C | ||||||||
| Address2: | |||||||||
| City: | HADDON TOWNSHIP | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081082634 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8568543155 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2017 | ||||||||
| LastUpdateDate: | 11/15/2017 | ||||||||
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| AuthorizedOfficialLastName: | FARKAS | ||||||||
| AuthorizedOfficialFirstName: | LISA | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8568543155 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PSY.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 35S100580500 | NJ | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.