Provider Demographics
NPI:1992171599
Name:INGRASSIO, DANIELLE ELIZABETH (MS)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:ELIZABETH
Last Name:INGRASSIO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:DANIELLE
Other - Middle Name:ELIZABETH
Other - Last Name:ANTONELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:43 KIRKLAND DR
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-1848
Mailing Address - Country:US
Mailing Address - Phone:585-721-7179
Mailing Address - Fax:
Practice Address - Street 1:1580 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-3620
Practice Address - Country:US
Practice Address - Phone:585-721-7179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY18 P99085101YM0800X
NY007806101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health