Provider Demographics
NPI:1407071541
Name:FARRELL, MARY A (MSW)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:A
Last Name:FARRELL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 ROTE HILL RD
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01257
Mailing Address - Country:US
Mailing Address - Phone:413-229-2838
Mailing Address - Fax:
Practice Address - Street 1:210 ROTE HILL RD
Practice Address - Street 2:
Practice Address - City:SHEFFIELD
Practice Address - State:MA
Practice Address - Zip Code:01257
Practice Address - Country:US
Practice Address - Phone:413-229-2838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1016276106H00000X
NYR29953106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist