Provider Demographics
NPI:1184714800
Name:MILES TIMINERI, LYNN E (LCSW-R)
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:E
Last Name:MILES TIMINERI
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 1:3300 MONROE AVE
Mailing Address - Street 2:SUITE 309
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-4624
Mailing Address - Country:US
Mailing Address - Phone:585-383-8710
Mailing Address - Fax:585-383-8609
Practice Address - Street 1:3300 MONROE AVE
Practice Address - Street 2:SUITE 309
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-4624
Practice Address - Country:US
Practice Address - Phone:585-383-8710
Practice Address - Fax:585-383-8609
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0286551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7300546OtherAETHNA HEALTH INS
NYP010028655OtherBLUE PRODUCTS