Provider Demographics
NPI:1255668364
Name:TURGEON, KRISTEN (LCSW)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:TURGEON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:TURGEON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:490 E RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-1229
Mailing Address - Country:US
Mailing Address - Phone:585-922-2663
Mailing Address - Fax:
Practice Address - Street 1:490 E RIDGE RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-1229
Practice Address - Country:US
Practice Address - Phone:585-922-2663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-10
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY079726-1104100000X
NY0833711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker