Provider Demographics
NPI:1528701521
Name:SPARACINO, BRITTANY LYNN (LMHC)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LYNN
Last Name:SPARACINO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1565 LONG POND RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4168
Mailing Address - Country:US
Mailing Address - Phone:585-723-7723
Mailing Address - Fax:585-723-7301
Practice Address - Street 1:1565 LONG POND RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4168
Practice Address - Country:US
Practice Address - Phone:585-723-7723
Practice Address - Fax:585-723-7301
Is Sole Proprietor?:No
Enumeration Date:2022-04-18
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011491-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03640439Medicaid