| Heather A Penrose Lcsw Psychotherapy Pllc | |
|
119 Averill Ave Rochester NY 14620-1317 | |
| (585) 330-9416 | |
| Not Available |
| Full Name | Heather A Penrose Lcsw Psychotherapy Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 119 Averill Ave, Rochester, New York |
| Authorized Official Name and Position | Heather Penrose (PSYCHOTHERAPIST) |
| Authorized Official Contact | 5855769415 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heather A Penrose Lcsw Psychotherapy Pllc 119 Averill Ave Rochester NY 14620-1317 Ph: (585) 330-9416 | Heather A Penrose Lcsw Psychotherapy Pllc 119 Averill Ave Rochester NY 14620-1317 Ph: (585) 330-9416 |
| NPI Number | 1982376877 |
|---|---|
| Provider Enumeration Date | 09/29/2021 |
| Last Update Date | 12/27/2023 |
| Certification Date | 12/27/2023 |
| Medicare PECOS PAC ID | 0244623544 |
|---|---|
| Medicare Enrollment ID | O20220209002003 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982376877 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Heather A Penrose |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831338003 PECOS PAC ID: 5597087064 Enrollment ID: I20141211001786 |
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