Individual provider Active NPI

Trisha Kilbourn, LCSW

  • Clinical Social Worker
  • Rochester, NY
National Provider Identifier
1679098958
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
09290801 Issued in NY
Practice address
2613 W Henrietta Rd
Rochester, NY 14623-2327
Phone
(585) 276-9270
NPI assigned
Aug 8, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NY
Social Worker 104100000X 0854691 NY
School Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041S0200X 733162131 NY
Clinical Social Worker 1041C0700X 09290801 NY Primary

Addresses

Primary practice location

2613 W Henrietta Rd
Rochester, NY 14623-2327

Mailing address

2613 W Henrietta Rd Ste E
Rochester, NY 14623-2327

Other practice location 1

1860 South Ave
Rochester, NY 14620-4229
Phone (585) 279-7800

Other practice location 2

4000 E Henrietta Rd
Henrietta, NY 14467-9704
Phone (585) 359-5000

Other practice location 3

639 Erie Station Rd
West Henrietta, NY 14586-9750
Phone (585) 359-5300

Other practice location 4

116 Ayer St
Rochester, NY 14615-2630
Phone (585) 362-1672

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0854691NYMDSocial Worker
09290801NYMDClinical Social Worker
733162131NYMDSchool Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester Department of Psychiatry Clinical Group Social Worker CurrentSince Aug 19, 2022 Accepting new patients
University of Rochester Single Specialty PastSince Sep 4, 2022 Accepting new patients

Locations

1860 South Ave
Rochester, NY 14620
Phone (585) 273-1776

2613 W Henrietta Rd
Rochester, NY 14623
Phone (585) 279-4900

2613 W Henrietta Rd
Ste E
Rochester, NY 14623

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1502150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1679098958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2613 W HENRIETTA RD STE E",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146232327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2613 W HENRIETTA RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146232327",
            "telephone_number": "585-276-9270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1860 South Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146204229",
            "country_code": "US",
            "telephone_number": "585-279-7800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4000 E Henrietta Rd",
            "address_purpose": "LOCATION",
            "city": "Henrietta",
            "state": "NY",
            "postal_code": "144679704",
            "country_code": "US",
            "telephone_number": "585-359-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "639 Erie Station Rd",
            "address_purpose": "LOCATION",
            "city": "West Henrietta",
            "state": "NY",
            "postal_code": "145869750",
            "country_code": "US",
            "telephone_number": "585-359-5300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "116 Ayer St",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146152630",
            "country_code": "US",
            "telephone_number": "585-362-1672",
            "fax_number": "585-362-1672",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILBOURN",
        "first_name": "TRISHA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-08",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "0854691",
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, School",
            "state": "NY",
            "license": "733162131",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "09290801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.