Healthcare Provider Details

I. General information

NPI: 1538569132
Provider Name (Legal Business Name): CAITLIN LESKOVICS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2014
Last Update Date: 09/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

87 CLINTON AVE N
ROCHESTER NY
14604-1455
US

IV. Provider business mailing address

87 CLINTON AVE N
ROCHESTER NY
14604-1455
US

V. Phone/Fax

Practice location:
  • Phone: 585-546-7220
  • Fax: 585-262-7198
Mailing address:
  • Phone: 585-546-7220
  • Fax: 585-262-7198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number090387-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: