Provider Demographics
NPI:1306406616
Name:LADELFA, ANNA NATALIE (MHC)
Entity Type:Individual
Prefix:MS
First Name:ANNA
Middle Name:NATALIE
Last Name:LADELFA
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PINEWILD DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14606-4200
Mailing Address - Country:US
Mailing Address - Phone:585-368-6700
Mailing Address - Fax:585-368-6767
Practice Address - Street 1:61 HULBURT AVE
Practice Address - Street 2:
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450-2407
Practice Address - Country:US
Practice Address - Phone:585-419-5851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP100617101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health