Healthcare Provider Details

I. General information

NPI: 1528735347
Provider Name (Legal Business Name): ELLEN FICHERA MHC-LP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2021
Last Update Date: 08/28/2021
Certification Date: 08/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 N MAIN ST
PITTSFORD NY
14534-4433
US

IV. Provider business mailing address

56 N MAIN ST
PITTSFORD NY
14534-4433
US

V. Phone/Fax

Practice location:
  • Phone: 585-524-0008
  • Fax:
Mailing address:
  • Phone: 585-524-0008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: