Provider Demographics
NPI:1487712857
Name:FARRELL, MELISSA LYNNE (MS, LMHC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:LYNNE
Last Name:FARRELL
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 QUAIL HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-1629
Mailing Address - Country:US
Mailing Address - Phone:716-491-3122
Mailing Address - Fax:
Practice Address - Street 1:121 QUAIL HOLLOW LN
Practice Address - Street 2:
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-1629
Practice Address - Country:US
Practice Address - Phone:716-491-3122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2023-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002912101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health