Provider Demographics
NPI:1013426188
Name:FARRELL, VALERIE ANNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:ANNE
Last Name:FARRELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:864 KINGS POST RD
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955
Mailing Address - Country:US
Mailing Address - Phone:321-506-3101
Mailing Address - Fax:
Practice Address - Street 1:13800 VETERAN'S WAY
Practice Address - Street 2:BLDG 9
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827
Practice Address - Country:US
Practice Address - Phone:407-631-7107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2017-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW103011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical