Provider Demographics
NPI:1487030961
Name:ELMER, MALORIE (LMHC)
Entity Type:Individual
Prefix:
First Name:MALORIE
Middle Name:
Last Name:ELMER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14611-1361
Mailing Address - Country:US
Mailing Address - Phone:585-368-4500
Mailing Address - Fax:585-436-6047
Practice Address - Street 1:158 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14611-1361
Practice Address - Country:US
Practice Address - Phone:585-368-4500
Practice Address - Fax:585-436-6047
Is Sole Proprietor?:No
Enumeration Date:2015-08-06
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007411101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health