Provider Demographics
NPI:1750419057
Name:FARRELL, CARLA (LCSW)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:
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 1:1160 OTTER CREEK RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37220-1700
Mailing Address - Country:US
Mailing Address - Phone:615-463-0282
Mailing Address - Fax:615-460-4109
Practice Address - Street 1:915 8TH AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208-2621
Practice Address - Country:US
Practice Address - Phone:615-460-4100
Practice Address - Fax:615-460-4109
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3937131101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health