Provider Demographics
NPI:1992058218
Name:BLEEG, MARJORIE T (LCSW-R)
Entity type:Individual
Prefix:
First Name:MARJORIE
Middle Name:T
Last Name:BLEEG
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:MARJORIE
Other - Middle Name:BLEEG
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:70 LINDEN OAKS
Mailing Address - Street 2:THIRD FLOOR
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2804
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:70 LINDEN OAKS
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2804
Practice Address - Country:US
Practice Address - Phone:585-383-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR020486-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical