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General NPI Number Information
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NPI Number | 1477323186
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Entity Type | Organization
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Legal Business Name | GREATER ROCHESTER AREA COMMUNITY EXPERIENCE LCSW PLLC
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Dates
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Enumeration Date | 01/03/2024
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Last Update Date | 01/03/2024
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Provider Practice Location Address
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Address Line | 36 WINTHROP ST
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City | ROCHESTER
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State | NY
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Zip | 14607-1326
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Country | US
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Telephone | 585-502-1445
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Fax | 585-625-0398
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Provider Business Mailing Address
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Address Line | 36 WINTHROP ST
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City | ROCHESTER
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State | NY
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Zip | 14607-1326
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Country | US
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Telephone | 585-502-1445
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Fax | 585-625-0398
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Authorized Official
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Title or Position | OWNER
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Name | VILMA L VENDRELL
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Credential | LCSW-R
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Telephone | 585-502-1445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #4
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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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