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NPI Code Detail

MEDICARE: MS. LINDA ALICE DONAHUE LCSW

MEDICARE: MS. LINDA ALICE DONAHUE 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
11041C0700XClinical Social Worker075852-1NY

General Provider Information

NPI Number : 1063794980
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LINDA ALICE DONAHUE LCSW
Provider Business Mailing Address
First Line : 1931 BUFFALO RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14624-1535
Country : US
Telephone Number : 585-777-3500
Fax Number : 585-429-5211
Provider Business Practice Location Address
First Line : 150 MOUNT HOPE AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14620-1016
Country : US
Telephone Number : 585-777-3555
Fax Number : 585-429-5211
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2011
Last Update Date : 09/16/2011

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