Provider Demographics
NPI:1093445363
Name:HERNANDEZ, SARALICIA (MFT-LP)
Entity type:Individual
Prefix:
First Name:SARALICIA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MFT-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 EAST AVE, SUITE 21. ROCHESTER, NY. 14610
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14610
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2300 EAST AVE, SUITE 21. ROCHESTER, NY. 14610
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14610
Practice Address - Country:US
Practice Address - Phone:585-505-1359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health