Provider Demographics
NPI:1780838748
Name:ROTUNDO CONJERTI, KRISTEN NOEL (LCSW)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:NOEL
Last Name:ROTUNDO CONJERTI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 ALEXANDER ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-4000
Mailing Address - Country:US
Mailing Address - Phone:585-922-7259
Mailing Address - Fax:
Practice Address - Street 1:500 WEBSTER AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-4732
Practice Address - Country:US
Practice Address - Phone:585-482-9290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY077649-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical