Healthcare Provider Details

I. General information

NPI: 1275464638
Provider Name (Legal Business Name): ELISA EVA-KRISTINA HALE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BEHAVIORAL HEALTH ACCESS & CRISIS CENTER (BHACC) 65 GENESEE STREET
ROCHESTER NY
14611
US

IV. Provider business mailing address

BEHAVIORAL HEALTH ACCESS & CRISIS CENTER (BHACC) 65 GENESEE STREET
ROCHESTER NY
14611
US

V. Phone/Fax

Practice location:
  • Phone: 585-368-3950
  • Fax: 585-368-3935
Mailing address:
  • Phone: 585-368-3950
  • Fax: 585-368-3935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number092149
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: