SARA LIEDTKE


Address: 1387 Fairport Rd Ste 504, Fairport, NY 14450-2003
Phone: 5854782560

SARA LIEDTKE (NPI# 1790132314) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1790132314
Entity Type Individual
Full Name SARA LIEDTKE
Credential LMHC
Practice Address 1387 Fairport Rd Ste 504
Fairport
NY 14450-2003
Mailing Address 42 Faraday St Apt 4
Rochester
NY 14610-1763
Practice Telephone 5854782560
Mailing Telephone 5854782560
Enumeration Date 2016-05-24
Last Update Date 2019-07-07
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YM0800X Counselor
Specialization: Mental Health
9880547 NY Behavioral Health & Social Service Providers

Office Location

Street Address 1387 FAIRPORT RD STE 504
City FAIRPORT
State NY
Zip Code 14450-2003

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1982255899 Stephanie Janet Catlin-rakoski Counselor 1387 Fairport Rd Bldg 500, Ste 540, Fairport, NY 14450 2019-09-23
1477011773 Meredith Noel Austin-appleton Pediatrics Pediatric Urgent Care of Rochester, 6687 Pittsford Palmyra Rd, Fairport, NY 14450 2019-03-05
1659852358 Linda Demme Registered Nurse 29 Pleasant St, Fairport, NY 14450 2018-08-22
1679075154 Tharaha Thavakumar Behavior Technician 6 N. Main Street, Fairport, NY 14450 2018-03-01
1295244309 Comprehensive Medicine, Pllc Psychiatry & Neurology 762 Crosskeys Office Park, Fairport, NY 14450 2017-09-21
1104353846 Courtney Chapman Student in an Organized Health Care Education/Training Program 4 Valais Ct, Fairport, NY 14450 2017-05-12
1477947786 Preston Orthodontics, Pllc Dentist 2154 Fairport Nine Mile Point Road, Fairport, NY 14450 2015-03-25
1154724334 Amanda Corrisa Kalsih Registered Nurse 95 Evergreen Circle, Fairport, NY 14450 2014-10-02
1295172153 Pamela Lea Alexander Skilled Nursing Facility 41 O,connor Road, Monroe #1 Boces, Fairport, NY 14450 2013-05-31
1255682084 Lauren Lashomb Specialist 6 North Main Street, Fairport, NY 14450 2012-09-19
Find all providers in zip 14450

Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1982255899 Stephanie Janet Catlin-rakoski Counselor 1387 Fairport Rd Bldg 500, Ste 540, Fairport, NY 14450 2019-09-23
1306406616 Anna Natalie Ladelfa Counselor 61 Hulburt Ave, Fairport, NY 14450-2407 2019-06-18
1205127685 Chad Everett Scott Counselor 102 West Ave, Fairport, NY 14450-2124 2011-04-20
1093024036 Katherine J. Steblen Counselor 450 Perinton Hills Office Park, Fairport, NY 14450-3609 2010-09-24
1083937288 Tiffany Laurice Collins Counselor 1349 Ayrault Rd, #93, Fairport, NY 14450-8942 2010-03-02
1962612044 Patricia Corona Dirisio Counselor 315 Packetts Lndg, Fairport, NY 14450-1567 2007-05-23
1841407236 Martha Howe Rossi Counselor 2 Woodcliff Ter, Fairport, NY 14450-4208 2007-05-17
1427146992 Patricia A Ronsvalle Counselor 85 Matthew Dr, Fairport, NY 14450-9338 2006-10-10
1487661864 Paul I. Schwartzman Counselor 307 Packetts Lndg, Fairport, NY 14450-1567 2006-08-01
1215416177 Erin Lindsay Cusanno Counselor 625 Ayrault Rd, Fairport, NY 14450-3076 2018-08-11
Find all providers in FAIRPORT

Competitor

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City FAIRPORT
Zip Code 14450

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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