Provider Demographics
NPI:1376952291
Name:KIZIELEWICZ, NANCY (EDD LMHC)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
Last Name:KIZIELEWICZ
Suffix:
Gender:F
Credentials:EDD LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 FAR VIEW HILLS RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-2005
Mailing Address - Country:US
Mailing Address - Phone:585-748-6409
Mailing Address - Fax:
Practice Address - Street 1:6 FAR VIEW HILLS RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-2005
Practice Address - Country:US
Practice Address - Phone:585-748-6409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000321-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health