Provider Demographics
NPI:1104355841
Name:FARRELL, PATRICIA ANNE (MSW, LCSW-C)
Entity Type:Individual
Prefix:PROF
First Name:PATRICIA
Middle Name:ANNE
Last Name:FARRELL
Suffix:
Gender:F
Credentials:MSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 HARCOURT RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21214-3409
Mailing Address - Country:US
Mailing Address - Phone:410-426-6642
Mailing Address - Fax:
Practice Address - Street 1:540 E BELVEDERE AVE STE 203
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-3750
Practice Address - Country:US
Practice Address - Phone:443-926-9115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-07
Last Update Date:2017-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD061501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical