Provider Demographics
NPI:1417028622
Name:YOUNG WOMEN'S CHRISTIAN ASSOCIATION OF ROCHESTER AND MONROE COUNTY
Entity Type:Organization
Organization Name:YOUNG WOMEN'S CHRISTIAN ASSOCIATION OF ROCHESTER AND MONROE COUNTY
Other - Org Name:YWCA OF ROCHESTER AND MONROE COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO AND PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-368-2280
Mailing Address - Street 1:175 CLINTON AVE N
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14604-1109
Mailing Address - Country:US
Mailing Address - Phone:585-546-5820
Mailing Address - Fax:585-546-1077
Practice Address - Street 1:175 CLINTON AVE N
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14604-1109
Practice Address - Country:US
Practice Address - Phone:585-546-5820
Practice Address - Fax:585-546-1077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01456702Medicaid