Organization
INTENTIONAL IMPACT LMSW PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CASWELL VINCENT SMITH LMSW (OWNER)
(585) 290-2224
Entity
Organization
Contact information
Practice address
1350 BUFFALO RD STE 18, ROCHESTER, NY 14624-1856
(585) 290-2224
Mailing address
547 CEDARWOOD TER, ROCHESTER, NY 14609-7154
(585) 290-2224
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
04/25/2021
Last updated
04/25/2021
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