Provider Demographics
NPI:1336117050
Name:WEEKS, CHARLENE M (LCSW)
Entity Type:Individual
Prefix:
First Name:CHARLENE
Middle Name:M
Last Name:WEEKS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CHARLENE
Other - Middle Name:MARIE
Other - Last Name:GREELEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:300 CRITTENDEN BLVD
Mailing Address - Street 2:BOX PSYCH
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642
Mailing Address - Country:US
Mailing Address - Phone:585-273-5701
Mailing Address - Fax:585-276-0161
Practice Address - Street 1:300 CRITTENDEN BLVD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642
Practice Address - Country:US
Practice Address - Phone:585-273-5701
Practice Address - Fax:585-276-0161
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY46857363AM0700X
NY0468571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical