Provider Demographics
NPI:1326432683
Name:FARRELL, SARAH MICHELLE (MSW, LSWAIC)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MICHELLE
Last Name:FARRELL
Suffix:
Gender:F
Credentials:MSW, LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1227 W CORONADO AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGECREST
Mailing Address - State:CA
Mailing Address - Zip Code:93555-4819
Mailing Address - Country:US
Mailing Address - Phone:760-608-7885
Mailing Address - Fax:
Practice Address - Street 1:24909 104TH AVE SE
Practice Address - Street 2:SUITE 101-A
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-2819
Practice Address - Country:US
Practice Address - Phone:760-608-7885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-25
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC605357481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical