National Provider Identifier

Peter L Wilder, LCSW-R

Peter L Wilder, LCSW-R is listed in the NPPES registry with a primary specialty of Clinical Social Worker in East Rochester, NY and a listed phone number of (585) 732-2192.

NPI 1235893371East Rochester, NYClinical Social Worker

Profile Overview

NPI
1235893371
Provider Type
Individual
Primary Specialty
Clinical Social Worker
Enumeration Date
October 25, 2021
Last Updated
October 25, 2021

Practice Location

  • 110 E Ivy St
  • East Rochester, NY 14445-1636

Phone: (585) 732-2192

Specialties

  • Clinical Social Worker (1041C0700X)
Full Record
NPI
1235893371
Entity Type
Individual
Last Name
Wilder
First Name
Peter
Middle Name
L
Credential
LCSW-R
Mailing Street Address
110 E Ivy St
Mailing City
East Rochester
Mailing State
NY
Mailing ZIP Code
14445-1636
Mailing Country
US
Mailing Phone
(585) 732-2192
Practice Street Address
110 E Ivy St
Practice City
East Rochester
Practice State
NY
Practice ZIP Code
14445-1636
Practice Country
US
Practice Phone
(585) 732-2192
Enumeration Date
October 25, 2021
Last Updated
October 25, 2021
Sex
Male
Sole Proprietor
Yes
Certification Date
October 25, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Clinical Social Worker (1041C0700X)