National Provider Identifier

Kathryn A Debruin, LCSW-R

Kathryn A Debruin, LCSW-R is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Canandaigua, NY and a listed phone number of (585) 396-4363.

NPI 1831203025Canandaigua, NYClinical Social Worker

Profile Overview

NPI
1831203025
Provider Type
Individual
Primary Specialty
Clinical Social Worker
Enumeration Date
August 18, 2006
Last Updated
July 09, 2007

Practice Location

  • 3019 County Complex Dr
  • Canandaigua, NY 14424-9505

Phone: (585) 396-4363

Mailing Address

  • 132 E Main St
  • Victor, NY 14564-1304

Specialties

  • Clinical Social Worker (1041C0700X)
Full Record
NPI
1831203025
Entity Type
Individual
Last Name
Debruin
First Name
Kathryn
Middle Name
A
Credential
LCSW-R
Provider Other Last Name
Pendergast
Provider Other First Name
Kathryn
Provider Other Last Name Type Code
1
Mailing Street Address
132 E Main St
Mailing City
Victor
Mailing State
NY
Mailing ZIP Code
14564-1304
Mailing Country
US
Mailing Phone
(585) 742-3804
Practice Street Address
3019 County Complex Dr
Practice City
Canandaigua
Practice State
NY
Practice ZIP Code
14424-9505
Practice Country
US
Practice Phone
(585) 396-4363
Practice Fax
(585) 396-4993
Enumeration Date
August 18, 2006
Last Updated
July 09, 2007
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Clinical Social Worker (1041C0700X)
Other Identifiers
103283EU (NY, Preferred Care), 07300045121 (NY), EM (NY, Excellus), 3109089 (NY, Value Options)