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General NPI Number Information
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NPI Number | 1730547423
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Entity Type | Organization
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Legal Business Name | ROCHESTER MENTAL HEALTH
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Dates
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Enumeration Date | 02/09/2016
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Last Update Date | 02/09/2016
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Provider Practice Location Address
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Address Line | 490 EAST RIDGE ROAD
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City | ROCHESTER
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State | NY
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Zip | 14621
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Country | US
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Telephone | 585-922-2506
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Fax |
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Provider Business Mailing Address
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Address Line | 490 E RIDGE RD
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City | ROCHESTER
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State | NY
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Zip | 14621-1229
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Country | US
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Telephone | 585-922-2526
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Fax |
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Authorized Official
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Title or Position | PRIMARY THERAPIST
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Name | MISS CEMRE KORMAN
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Credential | LMSW
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Telephone | 585-922-2602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 096695
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License Number State | NY
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