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General NPI Number Information
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NPI Number | 1285090738
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Entity Type | Individual
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Provider Name | KATHLEEN ELLIOTT LMHC 000874-1
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Gender | Female
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Dates
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Enumeration Date | 01/13/2016
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Last Update Date | 01/13/2016
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Provider Practice Location Address
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Address Line | 95 ALLENS CREEK RD BLDG 1 SUITE 311
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City | ROCHESTER
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State | NY
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Zip | 14618-3250
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Country | US
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Telephone | 585-270-1285
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Fax |
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Provider Business Mailing Address
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Address Line | 140 ASPEN DR
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City | ROCHESTER
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State | NY
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Zip | 14625-1512
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Country | US
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Telephone | 585-506-7191
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 000874-1
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License Number State | NY
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