Provider Demographics
NPI:1386308047
Name:RACZKIEWICZ, BRITTANY (LMSW)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:RACZKIEWICZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:MARIE
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:132 ALLENS CREEK RD STE 200
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-3310
Mailing Address - Country:US
Mailing Address - Phone:585-470-8483
Mailing Address - Fax:
Practice Address - Street 1:132 ALLENS CREEK RD STE 200
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-3310
Practice Address - Country:US
Practice Address - Phone:585-470-8483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY36516101YA0400X
NY112144104100000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker