National Provider Identifier
Mary Desantis, LCSW
Mary Desantis, LCSW is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Rochester, NY and a listed phone number of (585) 773-4396.
Profile Overview
- NPI
- 1134631310
- Provider Type
- Individual
- Primary Specialty
- Clinical Social Worker
- Enumeration Date
- October 28, 2017
- Last Updated
- May 01, 2023
Practice Location
- 945 E Henrietta RD Ste A-2
- Rochester, NY 14623-1419
Phone: (585) 773-4396
Specialties
- Clinical Social Worker (1041C0700X)
- Addiction (Substance Use Disorder) Counselor (101YA0400X)
- Social Worker (104100000X)
Full Record
- NPI
- 1134631310
- Entity Type
- Individual
- Last Name
- Desantis
- First Name
- Mary
- Credential
- LCSW
- Provider Other Last Name
- Gomez
- Provider Other First Name
- Mary
- Provider Other Credential Text
- LMSW
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 945 E Henrietta RD Ste A-2
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14623-1419
- Mailing Country
- US
- Mailing Phone
- (585) 773-4396
- Practice Street Address
- 945 E Henrietta RD Ste A-2
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14623-1419
- Practice Country
- US
- Practice Phone
- (585) 773-4396
- Enumeration Date
- October 28, 2017
- Last Updated
- May 01, 2023
- Sex
- Female
- Sole Proprietor
- Yes
- Taxonomy Group 2
- 193400000X Single Specialty Group
- Certification Date
- May 01, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Clinical Social Worker (1041C0700X), Addiction (Substance Use Disorder) Counselor (101YA0400X), Social Worker (104100000X)