Provider Demographics
NPI:1477723559
Name:CERVENY, WILLIAM J (LCSW)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:J
Last Name:CERVENY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5265 SENECA POINT RD
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-8921
Mailing Address - Country:US
Mailing Address - Phone:585-393-1106
Mailing Address - Fax:
Practice Address - Street 1:5265 SENECA POINT RD
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-8921
Practice Address - Country:US
Practice Address - Phone:585-393-1106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR022375-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical