Provider Demographics
NPI:1154815116
Name:FARRELL, MOLLY TERESA (LMFT)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:TERESA
Last Name:FARRELL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-1622
Mailing Address - Country:US
Mailing Address - Phone:585-641-0281
Mailing Address - Fax:585-641-0286
Practice Address - Street 1:1320 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-1622
Practice Address - Country:US
Practice Address - Phone:585-641-0281
Practice Address - Fax:585-641-0286
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
NY001347106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist