Provider Demographics
NPI:1295118057
Name:CENZI, JULIENNE R
Entity type:Individual
Prefix:MRS
First Name:JULIENNE
Middle Name:R
Last Name:CENZI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 LYNN DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14622-1353
Mailing Address - Country:US
Mailing Address - Phone:585-752-2095
Mailing Address - Fax:
Practice Address - Street 1:1815 CLINTON AVE S
Practice Address - Street 2:SUITE 630
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-5720
Practice Address - Country:US
Practice Address - Phone:585-752-2095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-29
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005649101YM0800X
NY000138103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health