MEDICARE: ANNETTE M. HERTZLIN-LOCKAMYEIR, LCSW PLLC

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	069241-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538241732
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANNETTE M. HERTZLIN-LOCKAMYEIR, LCSW PLLC

Provider Business Mailing Address
First Line	:	117 DELAINA ROSE CIR
Second Line	:
City	:	BROCKPORT
State	:	NY
Zip	:	14420-9344
Country	:	US
Telephone Number	:	585-303-3724
Fax Number	:

Provider Business Practice Location Address
First Line	:	27 S PLATT ST
Second Line	:
City	:	ALBION
State	:	NY
Zip	:	14411-1431
Country	:	US
Telephone Number	:	585-303-3724
Fax Number	:	585-589-1036

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. ANNETTE MARIE HERTZLIN-LOCKAMYEIR
Credential	:	L.C.S.W.-R
Telephone Number	:	585-303-3724

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	10/16/2008

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