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General NPI Number Information
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NPI Number | 1548277072
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Entity Type | Individual
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Provider Name | KATHY LYNN FARRELL LPC
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Gender | Female
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 6040 W LISBON AVE
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City | MILWAUKEE
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State | WI
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Zip | 53210-2116
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Country | US
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Telephone | 414-871-9111
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Fax | 414-871-9121
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Provider Business Mailing Address
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Address Line | 4230 LOCUST ST
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City | DELAVAN
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State | WI
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Zip | 53115-3441
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Country | US
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Telephone | 815-979-4033
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Fax | 262-806-7246
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 3473-125
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 3473-125
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3473-125
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License Number State | WI
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