=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275448292
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEAVEN SENT PEER SUPPORT LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/14/2026
-----------------------------------------------------
Last Update Date | 08/14/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 27 FONTANA LN
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14612-2973
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-664-9037
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 27 FONTANA LN
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14612-2973
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-664-9037
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PEER SPECIALIST
-----------------------------------------------------
Name | MELISSA CARO
-----------------------------------------------------
Credential | NYCPS,FPA,CRPA
-----------------------------------------------------
Telephone | 585-664-9037
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------