MEDICARE: STACEY MARIE REED-MACGREGOR MSW-LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	081629	NY

General Provider Information

NPI Number	:	1033534961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACEY MARIE REED-MACGREGOR MSW-LCSW

Provider Business Mailing Address
First Line	:	888 LONG POND RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14626-1111
Country	:	US
Telephone Number	:	585-730-7777
Fax Number	:	585-730-7779

Provider Business Practice Location Address
First Line	:	888 LONG POND RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14626-1111
Country	:	US
Telephone Number	:	585-730-7777
Fax Number	:	585-730-7779

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2014
Last Update Date	:	01/19/2016

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