Provider Demographics
NPI:1790591774
Name:B CALEY FAIN, LCSW PLLC
Entity type:Organization
Organization Name:B CALEY FAIN, LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:B CALEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FAIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:585-943-9196
Mailing Address - Street 1:2003 PEBBLEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:NY
Mailing Address - Zip Code:14564-9231
Mailing Address - Country:US
Mailing Address - Phone:585-943-9196
Mailing Address - Fax:
Practice Address - Street 1:3380 MONROE AVE STE 220
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-4726
Practice Address - Country:US
Practice Address - Phone:585-943-9196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty