| Judith Lundquist Lcsw Pllc | |
|
572 Titus Ave Ste B Rochester NY 14617-3519 | |
| (585) 451-5126 | |
| (585) 266-9336 |
| Full Name | Judith Lundquist Lcsw Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 572 Titus Ave, Rochester, New York |
| Authorized Official Name and Position | Judith Lundquist (OWNER) |
| Authorized Official Contact | 5854515126 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Judith Lundquist Lcsw Pllc 572 Titus Ave Ste B Rochester NY 14617-3519 Ph: (585) 451-5126 | Judith Lundquist Lcsw Pllc 572 Titus Ave Ste B Rochester NY 14617-3519 Ph: (585) 451-5126 |
| NPI Number | 1033466388 |
|---|---|
| Provider Enumeration Date | 08/06/2012 |
| Last Update Date | 08/06/2012 |
| Medicare PECOS PAC ID | 9335398056 |
|---|---|
| Medicare Enrollment ID | O20121012000206 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033466388 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | R0212601 (New York) | Primary |
| Provider Name | Judith A Lundquist |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588785182 PECOS PAC ID: 1850486978 Enrollment ID: I20071004000645 |
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