Healthcare Provider Details

I. General information

NPI: 1023642626
Provider Name (Legal Business Name): MICHELLE MCGLORY-WHYTE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2020
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 COULTER RD
CLIFTON SPRINGS NY
14432-1122
US

IV. Provider business mailing address

100 KINGS HWY S
ROCHESTER NY
14617-5504
US

V. Phone/Fax

Practice location:
  • Phone: 315-462-1050
  • Fax: 315-462-0145
Mailing address:
  • Phone: 585-922-5462
  • Fax: 585-922-1011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number089122
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: