Healthcare Provider Details

I. General information

NPI: 1487558912
Provider Name (Legal Business Name): KRISTEN ELIZABETH SOMERS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

274 N GOODMAN ST
ROCHESTER NY
14607-1154
US

IV. Provider business mailing address

50 MEADOW DR
SPENCERPORT NY
14559-1142
US

V. Phone/Fax

Practice location:
  • Phone: 585-313-9951
  • Fax:
Mailing address:
  • Phone: 585-703-5092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number131983
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: