Provider Demographics
NPI:1992212799
Name:ERLICHMAN, NICOLE BARI (LCSW-R)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:BARI
Last Name:ERLICHMAN
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:556 CLINTON AVE S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-1105
Mailing Address - Country:US
Mailing Address - Phone:585-442-8422
Mailing Address - Fax:585-442-8404
Practice Address - Street 1:556 CLINTON AVE S
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-1105
Practice Address - Country:US
Practice Address - Phone:585-442-8422
Practice Address - Fax:585-442-8494
Is Sole Proprietor?:No
Enumeration Date:2018-01-03
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO73890-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical