MEDICARE: MRS. MARIA BATTISTA HANCOCK LCAT, MT-BC

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	101YM0800X	Mental Health Counselor	05001078	NY

General Provider Information

NPI Number	:	1437383700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIA BATTISTA HANCOCK LCAT, MT-BC

Provider Business Mailing Address
First Line	:	11 PIPERS MEADOW TRL
Second Line	:
City	:	PENFIELD
State	:	NY
Zip	:	14526-1153
Country	:	US
Telephone Number	:	585-723-1772
Fax Number	:

Provider Business Practice Location Address
First Line	:	1387 FAIRPORT RD
Second Line	:	BUILDING 700
City	:	FAIRPORT
State	:	NY
Zip	:	14450-2003
Country	:	US
Telephone Number	:	585-978-1978
Fax Number	:

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

Provider Enumeration Date	:	05/14/2009
Last Update Date	:	05/14/2009

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