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General NPI Number Information
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NPI Number | 1336836592
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Entity Type | Organization
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Legal Business Name | DAY BREAK COUNSELING SERVICES LCSW, PLLC
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Dates
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Enumeration Date | 04/19/2023
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Last Update Date | 04/19/2023
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Provider Practice Location Address
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Address Line | 590 TITUS AVE
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City | ROCHESTER
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State | NY
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Zip | 14617-3919
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Country | US
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Telephone | 585-732-8829
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Fax | 585-385-4293
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Provider Business Mailing Address
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Address Line | PO BOX 14903
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City | ROCHESTER
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State | NY
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Zip | 14614-0903
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Country | US
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Telephone | 585-732-8829
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Fax | 585-385-4293
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Authorized Official
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Title or Position | OWNER
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Name | LISA MALEK
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Credential | LCSW-R
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Telephone | 585-732-8829
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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