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NPI Code Detail

MEDICARE: HEATHER ANNE PENROSE LCSW

MEDICARE: HEATHER ANNE PENROSE LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker080860NY

General Provider Information

NPI Number : 1831338003
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER ANNE PENROSE LCSW
Provider Business Mailing Address
First Line : 18 HARVARD ST
Second Line :
City : ROCHESTER
State : NY
Zip : 14607-2607
Country : US
Telephone Number : 585-576-9415
Fax Number :
Provider Business Practice Location Address
First Line : 18 HARVARD ST
Second Line :
City : ROCHESTER
State : NY
Zip : 14607-2607
Country : US
Telephone Number : 585-576-9415
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2009
Last Update Date : 10/01/2015

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