Individual
CAILLEY ALEXA WAYMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC, CASAC
Contact information
Practice address
20 OFFICE PKWY, PITTSFORD, NY 14534-1718
(585) 360-9763
Mailing address
10 TIMWAY CT, FAIRPORT, NY 14450-9736
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
24866
NY
101YM0800X
Mental Health Counselor
Primary
006815
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006815
LMHC
NY
01
—
24866
OASAS
NY
Enumeration date
09/25/2015
Last updated
09/25/2015
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