Catholic Charities Diocese of Rochester

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

CATHOLIC CHARITIES DIOCESE OF ROCHESTER

Practice address

34 E State St
Mount Morris, NY 14510-9727

Phone

(585) 658-4466

Fax

(585) 658-2513

NPI assigned

Jul 30, 2015

Organization subpart

Yes

Parent organization

CATHOLIC CHARITIES OF THE DIOCESE OF ROCHESTERAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Tabitha Jon Brewster, M.S.

Title

Executive Director

Phone

(585) 658-4466

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Catholic Charities of Livingston County Doing business as

Part of

Catholic Charities of the Diocese Rochester Inc

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1438214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471478400000",
    "number": "1114302247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 E STATE ST",
            "city": "MOUNT MORRIS",
            "state": "NY",
            "postal_code": "145109727",
            "telephone_number": "585-658-4466",
            "fax_number": "585-658-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 E STATE ST",
            "city": "MOUNT MORRIS",
            "state": "NY",
            "postal_code": "145109727",
            "telephone_number": "585-658-4466",
            "fax_number": "585-658-2513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC CHARITIES DIOCESE OF ROCHESTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CATHOLIC CHARITIES OF THE DIOCESE OF ROCHESTER",
        "enumeration_date": "2015-07-30",
        "last_updated": "2016-08-18",
        "status": "A",
        "authorized_official_last_name": "BREWSTER",
        "authorized_official_first_name": "TABITHA",
        "authorized_official_middle_name": "JON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "585-658-4466",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04439209",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Catholic Charities of Livingston County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elisabet Juana Butler
• Laurie A Calnan
• Ryan Calnan, PT, DPT
• Mylessia Jean Candie, RN
• Leslie Grayce Carpenter, RDH
• Mollie Wilson Chandler, RN
• Brandy Chapman
• Wendy Chapman
• Bernice Chichester
• Kareen Chung-Buchanan

• Preferred Provider Organization in Mount Morris, NY
• Providers in Mount Morris, NY by specialty
• Preferred Provider Organization in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.