MEDICARE: AMY FARRELL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	PC019240	PA

General Provider Information

NPI Number	:	1912861188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY FARRELL

Provider Business Mailing Address
First Line	:	315 SUMMIT AVE APT A3
Second Line	:
City	:	CANONSBURG
State	:	PA
Zip	:	15317-1648
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	315 SUMMIT AVE APT A3
Second Line	:
City	:	CANONSBURG
State	:	PA
Zip	:	15317-1648
Country	:	US
Telephone Number	:	716-378-4750
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	02/20/2026

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