National Provider Identifier

Dominique M Wilcox, SOCIAL WORK

Dominique M Wilcox, SOCIAL WORK is listed in the NPPES registry with a primary specialty of Mental Health Counselor in Rochester, NY and a listed phone number of (585) 410-3370.

NPI 1821848284Rochester, NYMental Health Counselor

Profile Overview

NPI
1821848284
Provider Type
Individual
Primary Specialty
Mental Health Counselor
Enumeration Date
March 26, 2024
Last Updated
March 26, 2024

Practice Location

  • 175 N Winton RD
  • Rochester, NY 14610-1936

Phone: (585) 410-3370

Mailing Address

  • 28 Bardin St
  • Rochester, NY 14615-3520

Specialties

  • Mental Health Counselor (101YM0800X)
Full Record
NPI
1821848284
Entity Type
Individual
Last Name
Wilcox
First Name
Dominique
Middle Name
M
Name Prefix
Mrs.
Credential
SOCIAL WORK
Provider Other Last Name
Peterson
Provider Other First Name
Dominique
Provider Other Middle Name
M
Provider Other Last Name Type Code
1
Mailing Street Address
28 Bardin St
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14615-3520
Mailing Country
US
Mailing Phone
(585) 957-8646
Practice Street Address
175 N Winton RD
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14610-1936
Practice Country
US
Practice Phone
(585) 410-3370
Practice Fax
(585) 978-7217
Enumeration Date
March 26, 2024
Last Updated
March 26, 2024
Sex
Female
Sole Proprietor
No
Certification Date
March 26, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Mental Health Counselor (101YM0800X)