Provider Demographics
NPI:1912984147
Name:PETRONIO, ANDREW MICHAEL (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:MICHAEL
Last Name:PETRONIO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 ALLENS CREEK ROAD
Mailing Address - Street 2:BUILDING 2, SUITE 219
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618
Mailing Address - Country:US
Mailing Address - Phone:585-484-7784
Mailing Address - Fax:
Practice Address - Street 1:95 ALLENS CREEK ROAD
Practice Address - Street 2:BUILDING 2, SUITE 219
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618
Practice Address - Country:US
Practice Address - Phone:585-484-7784
Practice Address - Fax:585-304-7397
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0715771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical