Individual provider Active NPI

Mary Constance Kiessling, LCSW

  • Clinical Social Worker
  • Rochester, NY
National Provider Identifier
1962510461
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
074189 Issued in NY
Practice address
224 Alexander St
Rochester, NY 14607-4002
Phone
(585) 922-7770
Fax
(585) 922-1985
NPI assigned
Aug 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 074189 NY Primary

Addresses

Primary practice location

224 Alexander St
Rochester, NY 14607-4002

Mailing address

PO Box 10787
Rochester, NY 14610-0787
Phone (585) 922-1122

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
074189NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1156550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962510461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10787",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146100787",
            "telephone_number": "585-922-1122",
            "fax_number": "585-922-1985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 ALEXANDER ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146074002",
            "telephone_number": "585-922-7770",
            "fax_number": "585-922-1985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIESSLING",
        "first_name": "MARY",
        "middle_name": "CONSTANCE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "074189",
            "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 Jul 8, 2007; 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.