Provider Demographics
NPI:1811229230
Name:PICCHI, STEPHEN FRANCIS (LCSW)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:FRANCIS
Last Name:PICCHI
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 WESTFALL RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-4645
Mailing Address - Country:US
Mailing Address - Phone:585-463-2600
Mailing Address - Fax:585-473-3697
Practice Address - Street 1:919 WESTFALL RD
Practice Address - Street 2:BLDG B, SUITE 230
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2638
Practice Address - Country:US
Practice Address - Phone:585-463-2600
Practice Address - Fax:585-473-3697
Is Sole Proprietor?:No
Enumeration Date:2010-02-10
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042746-1104100000X
DEQ1-00010711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEQ1-0001071OtherLCSW