Provider Demographics
NPI:1932910353
Name:FARREN, MARSHALL (LPC)
Entity type:Individual
Prefix:MR
First Name:MARSHALL
Middle Name:
Last Name:FARREN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:553 W OAKDALE AVE APT 305
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-5726
Mailing Address - Country:US
Mailing Address - Phone:317-517-7016
Mailing Address - Fax:
Practice Address - Street 1:910 SKOKIE BLVD STE 215
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-4033
Practice Address - Country:US
Practice Address - Phone:317-517-7016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.021154101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health