Provider Demographics
NPI:1992879928
Name:MT CARMEL GUILD BEHAVIORAL HEALTHCARE
Entity type:Organization
Organization Name:MT CARMEL GUILD BEHAVIORAL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LANA
Authorized Official - Middle Name:
Authorized Official - Last Name:FARINA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:973-639-5044
Mailing Address - Street 1:1160 RAYMOND BLVD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102-4168
Mailing Address - Country:US
Mailing Address - Phone:973-596-3925
Mailing Address - Fax:973-596-3869
Practice Address - Street 1:1160 RAYMOND BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-4168
Practice Address - Country:US
Practice Address - Phone:973-596-3925
Practice Address - Fax:973-596-3869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital