SARA LIEDTKE (NPI# 1790132314) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YM0800X |
Counselor Specialization: Mental Health |
9880547 | NY | Behavioral Health & Social Service Providers |
Street Address |
1387 FAIRPORT RD STE 504 |
City | FAIRPORT |
State | NY |
Zip Code | 14450-2003 |
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 Code | 101YM0800X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Mental Health |
Definition to come... |
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 |
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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.