Individual ProviderSusan Sanford FarrelllyCounselorBehavioral Health & Social Service ProvidersPractice Address1014 Main Street, Vancouver, WA 98661(360) 695-1014PECOS EnrollmentBased on the most recent information from CMS, provider Susan Sanford Farrellly does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:04 AM.Profile DetailsProvider ID1588807960Provider TypeIndividualFull NameFarrellly, Susan SanfordCredentialMS, CRCGenderFemaleSole ProprietorYesEnumeration Date4/14/2009Last Updated1/6/2012Contact InformationPractice LocationPractice Address1014 Main Street, Vancouver, WA 98661Phone(360) 695-1014Fax(360) 750-1374Mailing LocationMailing Address1014 Main Street, Vancouver, WA 98661Phone(360) 695-1014Fax(360) 750-1374Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerWashington