Provider Demographics
NPI:1790400695
Name:KALMUS, ALISSA MICHELLE (LPMFT)
Entity Type:Individual
Prefix:
First Name:ALISSA
Middle Name:MICHELLE
Last Name:KALMUS
Suffix:
Gender:F
Credentials:LPMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 HIGH POINT TRL
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-2961
Mailing Address - Country:US
Mailing Address - Phone:585-749-2210
Mailing Address - Fax:
Practice Address - Street 1:625 PANORAMA TRL STE 3200
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2431
Practice Address - Country:US
Practice Address - Phone:585-865-3584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY118393-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health