Provider Demographics
NPI:1588935282
Name:FARRELL, TIMOTHY (MSW)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:
Last Name:FARRELL
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1465 HOOKSETT RD
Mailing Address - Street 2:SUSSEX #234
Mailing Address - City:HOOKSETT
Mailing Address - State:NH
Mailing Address - Zip Code:03106-1860
Mailing Address - Country:US
Mailing Address - Phone:603-268-0306
Mailing Address - Fax:603-268-0532
Practice Address - Street 1:665 BEACON ST
Practice Address - Street 2:SUITE 100
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-3202
Practice Address - Country:US
Practice Address - Phone:617-424-0665
Practice Address - Fax:617-424-0254
Is Sole Proprietor?:No
Enumeration Date:2012-01-26
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker