Individual
AMY THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
556 CLINTON AVE S, ROCHESTER, NY 14620-1105
(585) 442-8422
Mailing address
79 GLENRIDGE RD, GLENVILLE, NY 12302-4523
(585) 442-8422
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18713
NY
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01420800
—
NY
Enumeration date
06/30/2010
Last updated
04/29/2021
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