Healthcare Provider Details

I. General information

NPI: 1326301631
Provider Name (Legal Business Name): KATHRYN H COLLINA LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHY COLLINA LMHC

II. Dates (important events)

Enumeration Date: 06/21/2012
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 E RIDGE RD
ROCHESTER NY
14621-1229
US

IV. Provider business mailing address

100 KINGS HWY S
ROCHESTER NY
14617-5504
US

V. Phone/Fax

Practice location:
  • Phone: 585-922-2500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number005019
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: