Healthcare Provider Details

I. General information

NPI: 1528075710
Provider Name (Legal Business Name): SCOTT R.W. GREFRATH LCSW-R
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 04/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 TROUP ST
ROCHESTER NY
14608-2053
US

IV. Provider business mailing address

31 BIRCHWOOD DR
BATAVIA NY
14020-2944
US

V. Phone/Fax

Practice location:
  • Phone: 585-546-1271
  • Fax: 585-546-2607
Mailing address:
  • Phone: 585-356-1744
  • Fax: 585-219-4583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR074546-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: