Provider Demographics
NPI:1245962091
Name:PETRONIO COUNSELING - LCSW, PLLC
Entity type:Organization
Organization Name:PETRONIO COUNSELING - LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:PETRONIO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSWR
Authorized Official - Phone:585-484-7784
Mailing Address - Street 1:95 ALLENS CREEK ROAD
Mailing Address - Street 2:BUILDING 2, SUITE 219
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618
Mailing Address - Country:US
Mailing Address - Phone:585-484-7784
Mailing Address - Fax:585-304-7397
Practice Address - Street 1:95 ALLENS CREEK ROAD
Practice Address - Street 2:BUILDING 2, SUITE 219
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618
Practice Address - Country:US
Practice Address - Phone:585-484-7784
Practice Address - Fax:585-304-7397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty