Healthcare Provider Details

I. General information

NPI: 1528577434
Provider Name (Legal Business Name): JOY C FARRELL LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2017
Last Update Date: 09/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 PINE WEST PLZ
ALBANY NY
12205-5593
US

IV. Provider business mailing address

110 DUMBARTON DR
DELMAR NY
12054-4408
US

V. Phone/Fax

Practice location:
  • Phone: 518-452-4232
  • Fax:
Mailing address:
  • Phone: 518-796-6172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number008153
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: