Provider Demographics
NPI:1245058833
Name:PITTSFORD THERAPY, LCSW, PLLC
Entity type:Organization
Organization Name:PITTSFORD THERAPY, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GASCON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:585-364-2545
Mailing Address - Street 1:31 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-4432
Mailing Address - Country:US
Mailing Address - Phone:585-364-2545
Mailing Address - Fax:
Practice Address - Street 1:31 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-4432
Practice Address - Country:US
Practice Address - Phone:585-364-2545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty