Healthcare Provider Details
I. General information
NPI: 1295652147
Provider Name (Legal Business Name): CLINICAL PSYCHOLOGISTS OF ROCHESTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
877 ELMWOOD AVE
ROCHESTER NY
14620-2933
US
IV. Provider business mailing address
877 ELMWOOD AVE
ROCHESTER NY
14620-2933
US
V. Phone/Fax
- Phone: 585-739-5155
- Fax:
- Phone: 585-739-5155
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JENNIFER
BLENDER
Title or Position: OWNER
Credential: PHD
Phone: 585-739-5155