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:
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Health care specialties

SpecialtyCodeLicense #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 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376690891 NPPES
Nebraska MEDICAID 47084125026
Nebraska Other 82697
Nebraska MEDICAID 10024982600

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