Provider Demographics
NPI:1093220220
Name:GREISCH, STEFANIE M (LCSW)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:M
Last Name:GREISCH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CANTERBURY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-3446
Mailing Address - Country:US
Mailing Address - Phone:585-749-4868
Mailing Address - Fax:
Practice Address - Street 1:25 CANTERBURY RD STE 100
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-3446
Practice Address - Country:US
Practice Address - Phone:585-749-4868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0899051041C0700X
NY075708104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker