Provider Demographics
NPI:1417169293
Name:SEXSMITH, MICHELE ANN (MS, LCAT)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:ANN
Last Name:SEXSMITH
Suffix:
Gender:F
Credentials:MS, LCAT
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:ANN
Other - Last Name:STRAZZERI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,LCAT
Mailing Address - Street 1:1486 LAUREL LN
Mailing Address - Street 2:
Mailing Address - City:HORNELL
Mailing Address - State:NY
Mailing Address - Zip Code:14843-1135
Mailing Address - Country:US
Mailing Address - Phone:607-324-4420
Mailing Address - Fax:
Practice Address - Street 1:280 PRINCETON AVENUE EXT
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:NY
Practice Address - Zip Code:14830-1524
Practice Address - Country:US
Practice Address - Phone:607-962-3148
Practice Address - Fax:607-962-8422
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY05-000463101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor