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General NPI Number Information
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NPI Number | 1427870658
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Entity Type | Individual
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Provider Name | AVA FARRELL LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/29/2024
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 75 FRANCIS STREET
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City | BOSTON
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State | MA
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Zip | 02115
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Country | US
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Telephone | 617-525-6915
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Fax |
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Provider Business Mailing Address
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Address Line | 17 BOWDOIN STREET 1
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City | CAMBRIDGE
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State | MA
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Zip | 02138
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Country | US
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Telephone | 301-651-4606
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LCSW230659
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License Number State | MA
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