Provider Demographics
NPI:1639518756
Name:PITRE-CHESTNUT, CLARA B (LMFT)
Entity Type:Individual
Prefix:
First Name:CLARA
Middle Name:B
Last Name:PITRE-CHESTNUT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 HUMBOLDT ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14610-1059
Mailing Address - Country:US
Mailing Address - Phone:585-420-8691
Mailing Address - Fax:
Practice Address - Street 1:175 HUMBOLDT ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14610-1059
Practice Address - Country:US
Practice Address - Phone:585-420-8691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-21
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001323106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist