National Provider Identifier

Kimberly Rose Peterson, LMSW

Kimberly Rose Peterson, LMSW is listed in the NPPES registry with a primary specialty of Mental Health Counselor in Canandaigua, NY and a listed phone number of (585) 615-0183.

NPI 1467955724Canandaigua, NYMental Health Counselor

Profile Overview

NPI
1467955724
Provider Type
Individual
Primary Specialty
Mental Health Counselor
Enumeration Date
March 13, 2018
Last Updated
July 14, 2023

Practice Location

  • 400 Fort Hill Ave
  • Canandaigua, NY 14424-1159

Phone: (585) 615-0183

Specialties

  • Mental Health Counselor (101YM0800X)
Full Record
NPI
1467955724
Entity Type
Individual
Last Name
Peterson
First Name
Kimberly
Middle Name
Rose
Credential
LMSW
Mailing Street Address
400 Fort Hill Ave
Mailing City
Canandaigua
Mailing State
NY
Mailing ZIP Code
14424-1159
Mailing Country
US
Mailing Phone
(585) 615-0183
Practice Street Address
400 Fort Hill Ave
Practice City
Canandaigua
Practice State
NY
Practice ZIP Code
14424-1159
Practice Country
US
Practice Phone
(585) 615-0183
Enumeration Date
March 13, 2018
Last Updated
July 14, 2023
Sex
Female
Sole Proprietor
Yes
Taxonomy Group 1
193200000X Multi-Specialty Group
Certification Date
July 14, 2023
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Mental Health Counselor (101YM0800X)