Fardella, Tina L
Fardella, Tina L is an individual health care provider with primary practice located at 5600 S 59Th St Ste 104 Orr Psychotherapy Resources, Lincoln NE 68516-2387. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Fardella, Tina L can be contacted via phone (402) 484-0595.Contact Information
Primary practice address
5600 S 59Th St Ste 104 Orr Psychotherapy Resources
Lincoln NE 68516-2387
Phone: (402) 484-0595
Fax: (402) 484-0595
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Professional | 101YP2500X | 2525 | Nebraska |
Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 1058 | Nebraska |
Profile Details
NPI number | 1376690891 |
---|---|
LBN Legal business name | Fardella, Tina L |
Credentials | LMHP LCSW |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 5th, 2007 |
Last updated | Dec 20th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1376690891 | NPPES |
Nebraska | MEDICAID | 47084125026 | |
Nebraska | Other | 82697 | |
Nebraska | MEDICAID | 10024982600 |
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