Provider Demographics
NPI:1528821717
Name:GAESSER, AMY HEGEMAN (PHD, NCC, MHC-LP)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:HEGEMAN
Last Name:GAESSER
Suffix:
Gender:F
Credentials:PHD, NCC, MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 WINSTON WOODS
Mailing Address - Street 2:
Mailing Address - City:BROCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14420-2064
Mailing Address - Country:US
Mailing Address - Phone:585-752-0662
Mailing Address - Fax:
Practice Address - Street 1:12 AMITY ST
Practice Address - Street 2:
Practice Address - City:SPENCERPORT
Practice Address - State:NY
Practice Address - Zip Code:14559-1350
Practice Address - Country:US
Practice Address - Phone:585-210-3337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP104908101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health