Provider Demographics
NPI:1386770097
Name:ROEMER-KOKE, ALANNA (LCSW-R)
Entity type:Individual
Prefix:
First Name:ALANNA
Middle Name:
Last Name:ROEMER-KOKE
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:ALANNA
Other - Middle Name:C
Other - Last Name:ROEMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:14 CABOOSE CIR
Mailing Address - Street 2:
Mailing Address - City:NORTH CHILI
Mailing Address - State:NY
Mailing Address - Zip Code:14514-9710
Mailing Address - Country:US
Mailing Address - Phone:585-415-7620
Mailing Address - Fax:
Practice Address - Street 1:2006 FIVE MILE LINE RD
Practice Address - Street 2:
Practice Address - City:PENFIELD
Practice Address - State:NY
Practice Address - Zip Code:14526-1419
Practice Address - Country:US
Practice Address - Phone:585-381-0282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY700701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA7493Medicare ID - Type Unspecified