Provider Demographics
NPI:1336529973
Name:MACLEOD, MARY ZAGARI KAMPF (PHD, LCSW-R)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:ZAGARI KAMPF
Last Name:MACLEOD
Suffix:
Gender:F
Credentials:PHD, LCSW-R
Other - Prefix:DR
Other - First Name:MARY
Other - Middle Name:ZAGARI KAMPF
Other - Last Name:MACLEOD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD,LCSW-R, ACS, CGP
Mailing Address - Street 1:95 ALLENS CREEK ROAD
Mailing Address - Street 2:BLD. 1 SUITE 250
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618
Mailing Address - Country:US
Mailing Address - Phone:585-364-2050
Mailing Address - Fax:
Practice Address - Street 1:95 ALLENS CREEK ROAD
Practice Address - Street 2:BLDG 1 SUITE 250
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618
Practice Address - Country:US
Practice Address - Phone:585-364-2050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-08
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0805231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical