Basic Information
Provider Information
NPI: 1790110609
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FARRELL
FirstName: DEBRA
MiddleName: A
NamePrefix: MS.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 238 S. WEST STREET
Address2:  
City: CARLISLE
State: PA
PostalCode: 17013
CountryCode: US
TelephoneNumber: 7176093461
FaxNumber:  
Practice Location
Address1: 960 CENTURY DR
Address2:  
City: MECHANICSBURG
State: PA
PostalCode: 170554374
CountryCode: US
TelephoneNumber: 7177950330
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/10/2013
LastUpdateDate: 09/10/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000X  Y Behavioral Health & Social Service ProvidersCounselor 

No ID Information.


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