Provider Demographics
NPI:1316101959
Name:DINARDO-PRIEBE, MICHELE (LCSW-R)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:DINARDO-PRIEBE
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1387 FAIRPORT RD
Mailing Address - Street 2:BUILDING 500, SUITE 540
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-2003
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1387 FAIRPORT RD
Practice Address - Street 2:BUILDING 500, SUITE 540
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450-2003
Practice Address - Country:US
Practice Address - Phone:585-503-8246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY73 0751331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical