Healthcare Provider Details

I. General information

NPI: 1548542699
Provider Name (Legal Business Name): SARAH ANNLEE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2011
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

259 MONROE AVE
ROCHESTER NY
14607-3632
US

IV. Provider business mailing address

259 MONROE AVE
ROCHESTER NY
14607-3632
US

V. Phone/Fax

Practice location:
  • Phone: 585-545-7200
  • Fax: 585-244-8177
Mailing address:
  • Phone: 585-545-7200
  • Fax: 585-232-1553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number072414-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number1252171
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: