National Provider Identifier
Wide Waters Therapy Services Lcsw PLLC
Wide Waters Therapy Services Lcsw PLLC is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Rochester, NY and a listed phone number of (585) 206-2631.
Profile Overview
- NPI
- 1215609524
- Provider Type
- Organization
- Primary Specialty
- Clinical Social Worker
- Enumeration Date
- October 05, 2021
- Last Updated
- January 02, 2026
Practice Location
- 274 N. Goodman St.
- Suite A300
- Rochester, NY 14607
Phone: (585) 206-2631
Specialties
- Clinical Social Worker (1041C0700X)
Full Record
- NPI
- 1215609524
- Entity Type
- Organization
- EIN
- <UNAVAIL>
- Organization Name
- Wide Waters Therapy Services Lcsw PLLC
- Mailing Street Address
- 274 N. Goodman St.
- Mailing Address Line 2
- Suite A300
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14607
- Mailing Country
- US
- Mailing Phone
- (585) 206-2631
- Mailing Fax
- (585) 206-1006
- Practice Street Address
- 274 N. Goodman St.
- Practice Address Line 2
- Suite A300
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14607
- Practice Country
- US
- Practice Phone
- (585) 206-2631
- Practice Fax
- (585) 206-1006
- Enumeration Date
- October 05, 2021
- Last Updated
- January 02, 2026
- Authorized Official Last Name
- Adams
- Authorized Official First Name
- Sara
- Authorized Official Title
- Owner/Director
- Authorized Official Phone
- (585) 206-1130
- Organization Subpart
- No
- Authorized Official Name Prefix Text
- Mrs.
- Authorized Official Credential Text
- LCSW-R
- Taxonomy Group 1
- 193400000X Single Specialty Group
- Certification Date
- January 02, 2026
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Clinical Social Worker (1041C0700X)