Provider Demographics
NPI:1568940955
Name:PANAGIOTATOS, SANDIMARIE (LMHC, CASAC-T, NCC)
Entity Type:Individual
Prefix:
First Name:SANDIMARIE
Middle Name:
Last Name:PANAGIOTATOS
Suffix:
Gender:F
Credentials:LMHC, CASAC-T, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 TARRINGTON RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-5712
Mailing Address - Country:US
Mailing Address - Phone:585-673-0177
Mailing Address - Fax:
Practice Address - Street 1:501 TARRINGTON RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-5712
Practice Address - Country:US
Practice Address - Phone:585-673-0177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-30
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010522-01101Y00000X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor