MEDICARE: KRISTA KNOWLTON

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
1	101YM0800X	Mental Health Counselor		NY

General Provider Information

NPI Number	:	1881549020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTA KNOWLTON

Provider Business Mailing Address
First Line	:	28 GREENING CT
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14625-1132
Country	:	US
Telephone Number	:	607-368-3225
Fax Number	:

Provider Business Practice Location Address
First Line	:	81 LAKE AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14608-1410
Country	:	US
Telephone Number	:	585-368-6900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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Directions to “ KRISTA KNOWLTON ” Practice Location

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