Individual
JENNIFER FARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
15850 W BLUEMOUND RD, BROOKFIELD, WI 53005-6022
(262) 719-3824
(262) 641-9040
Mailing address
15850 W BLUEMOUND RD, BROOKFIELD, WI 53005-6022
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
554
WY
101Y00000X
Counselor
LPC-1270
WY
101YP2500X
Professional Counselor
Primary
5802-125
WI
101YP2500X
Professional Counselor
LPC-1270
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
554
STATE
WY
01
—
LPC 5802-125
LICENSE
WI
01
—
LPC-1270
STATE LICENCE
WY
Enumeration date
10/25/2011
Last updated
10/26/2015
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