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General NPI Number Information
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NPI Number | 1144975434
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Entity Type | Individual
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Provider Name | SAMANTHA SUZANNE LINDSEY
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Gender | Female
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Dates
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Enumeration Date | 02/16/2022
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Last Update Date | 07/29/2022
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Provider Practice Location Address
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Address Line | 556 CLINTON AVE S
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City | ROCHESTER
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State | NY
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Zip | 14620-1105
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Country | US
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Telephone | 585-442-8422
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Fax | 585-442-8494
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Provider Business Mailing Address
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Address Line | 156 QUINN RD
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City | ROCHESTER
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State | NY
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Zip | 14623-4048
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 367345
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License Number State | NY
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