Healthcare Provider Details

I. General information

NPI: 1184545626
Provider Name (Legal Business Name): HARBOR CLINICAL SERVICES LCSW PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 ALLENS CREEK RD STE 120
ROCHESTER NY
14618-3307
US

IV. Provider business mailing address

140 ALLENS CREEK RD STE 120
ROCHESTER NY
14618-3307
US

V. Phone/Fax

Practice location:
  • Phone: 585-575-2869
  • Fax: 585-287-5076
Mailing address:
  • Phone: 585-575-2869
  • Fax: 585-287-5076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: BRENDA MCQUILLAN
Title or Position: OWNER/CLINICAL SUPERVISOR
Credential: LCSW
Phone: 585-575-2869