Victoria Ennis Bridges, LCSW
Individual provider Active NPI Clinical Social Worker · Canandaigua, NY
NPI 1265638597 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1265638597
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 2001031824 (MO)
- Practice address
- 400 Fort Hill Ave
Canandaigua, NY 14424-1159 - Phone
- (585) 393-7770
- NPI assigned
- Jun 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2001031824 | MO | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2001031824 | MO | Yes |
Addresses
Primary practice location
400 Fort Hill Ave
Canandaigua, NY 14424-1159
Mailing address
5563 Centerpointe Blvd
Apt. 6
Canandaigua, NY 14424-7832
Phone (585) 394-8077
Other providers in Canandaigua, NY
- Emily Suzanne Bower
- Brianna L Bowers
- Jennifer Boyce
- Susan J Boyle-Osier
- Kathleen Mae Bremer
- Jason Briggs
- Katie Lynne Briggs
- Yvette Brindle-Decancq
- Cory Bristol
- Linda R. Broberg
All providers in Canandaigua, NY · Clinical Social Worker in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.