Healthcare Provider Details

I. General information

NPI: 1205951407
Provider Name (Legal Business Name): CATHERINE JEANNE FARRELL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CATHERINE JEANNE BLEAU FARRELL LCSW

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 GOETHALS DR
ROCHESTER NY
14616-1928
US

IV. Provider business mailing address

142 GOETHALS DR
ROCHESTER NY
14616-1928
US

V. Phone/Fax

Practice location:
  • Phone: 585-233-1334
  • Fax: 585-225-0188
Mailing address:
  • Phone: 585-233-1334
  • Fax: 585-225-0188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR050028-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: