Provider Demographics
NPI:1437429974
Name:FARRELL, MARYELIZABETH (MACP)
Entity Type:Individual
Prefix:MRS
First Name:MARYELIZABETH
Middle Name:
Last Name:FARRELL
Suffix:
Gender:F
Credentials:MACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 TUTTLE PL
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-1870
Mailing Address - Country:US
Mailing Address - Phone:860-632-3235
Mailing Address - Fax:860-632-3230
Practice Address - Street 1:20 TUTTLE PL
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-1870
Practice Address - Country:US
Practice Address - Phone:860-632-3235
Practice Address - Fax:860-632-3230
Is Sole Proprietor?:No
Enumeration Date:2011-12-30
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health