Logan Farrelly, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW12901 Issued in FL

Practice address

3015 Parental Home Rd
Jacksonville, FL 32216-5768

Phone

(904) 725-6662

NPI assigned

Oct 17, 2016

Last updated

Nov 9, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Youth Crisis Center, Inc.

  • Community/Behavioral Health Agency
  • Jacksonville, FL
  • NPI 1770884686
  NPD (past)

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1427509207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 PARENTAL HOME RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165704",
            "telephone_number": "904-725-6662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 PARENTAL HOME RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165768",
            "telephone_number": "904-725-6662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRELLY",
        "first_name": "LOGAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117887700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alison Farrell
• Jessica Farrell
• Karen Hune Farrell, PT
• Quentina Shauntira Farrell, LCSW
• Thomas Raymond Farrell IV
• Houssam Farres, MD
• Jane Ellen Farrington, ARNP
• Sarah Chapman Farris, CRNA
• Jeanette Farrow, RCSWI
• Natasha Guerra Farrow, ARNP

• Clinical Social Worker in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; 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.