Provider Demographics
NPI:1992046726
Name:JACQUELINE FARNESE, PSY.D., LLC
Entity type:Organization
Organization Name:JACQUELINE FARNESE, PSY.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:FARNESE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:609-452-9794
Mailing Address - Street 1:109 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:BORDENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08505-1853
Mailing Address - Country:US
Mailing Address - Phone:732-618-2969
Mailing Address - Fax:
Practice Address - Street 1:109 SPRING ST
Practice Address - Street 2:
Practice Address - City:BORDENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08505-1853
Practice Address - Country:US
Practice Address - Phone:732-618-2969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-04
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty