Provider Demographics
NPI:1669745295
Name:FARRELL, MELISSA ANN (LCSW)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
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 1:7105 WOODIBIS DR
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654-5926
Mailing Address - Country:US
Mailing Address - Phone:727-848-0185
Mailing Address - Fax:888-289-2159
Practice Address - Street 1:7105 WOODIBIS DR
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654-5926
Practice Address - Country:US
Practice Address - Phone:727-848-0185
Practice Address - Fax:888-289-2159
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-13
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW106521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical