Healthcare Provider Details

I. General information

NPI: 1306438338
Provider Name (Legal Business Name): ALEXANDRIA MARIE GOBEN LCAT, ATR-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXANDRIA MARIE ROBERTS LCAT, ATR-BC

II. Dates (important events)

Enumeration Date: 02/10/2021
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 UNIVERSITY AVE
ROCHESTER NY
14607-1226
US

IV. Provider business mailing address

433 WILLIAM ST
GENEVA NY
14456-2115
US

V. Phone/Fax

Practice location:
  • Phone: 585-557-1133
  • Fax:
Mailing address:
  • Phone: 315-521-7025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number002067
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number002067
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: