Provider Information for 1811644479
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AMY STOLBERG, LCSW, PC
Organization Subpart: NO
NPI: 1811644479
Last Updated: 2023-01-13
Certification Date: 2023-01-13
Certification Date: 2023-01-13
Details
| Name | Value | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1811644479 | ||||||||||||||
| Enumeration Date | 2022-03-03 | ||||||||||||||
| NPI Type | NPI-2 Organization | ||||||||||||||
| Status | Active | ||||||||||||||
| Authorized Official Information | Name: AMY N STOLBERG LCSW Title: Owner/ Provider Phone: 5857396968 | ||||||||||||||
| Mailing Address | 76 SONORA PKWY ROCHESTER, NY 14618-1314 United States Phone: 585-739-6968 | Fax: | ||||||||||||||
| Primary Practice Address | 919 WINTON RD S STE 211 ROCHESTER, NY 14618-1637 United States Phone: 585-739-6968 | Fax: | ||||||||||||||
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