Thais Colleen Farrell, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC012342 Issued in PA

Practice address

1080 N Delaware Ave Ste 600
Philadelphia, PA 19125-4339

Phone

(215) 496-0707

NPI assigned

Feb 19, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1613692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1134712243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 MEMPHIS ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191252232",
            "telephone_number": "610-733-6221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 N DELAWARE AVE STE 600",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191254339",
            "telephone_number": "215-496-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "THAIS",
        "middle_name": "COLLEEN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-19",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC012342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thais.farrell@cctckids.org",
            "affiliation": "N",
            "address_1": "1080 N Delaware Ave Ste 600",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191254339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patrick L Farrell
• Paul E Farrell, M.D.
• Sarah E. Farrell, CRNP
• Sharon Blakeny Farrell, CRNP
• Terence P Farrell, MB BCH BAO
• Thomas Farrell, PA-C
• Cormac Farrelly, MD
• Grace Bernadette Farrelly, OT/L
• Thomas R Farrelly, LCSW
• Khalifa Sady Farroukh, DDS

• Professional Counselor in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.