Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Ontario County

Organization Psychologist · NPI 1003802190

Ontario County provides Psychologist services in Canandaigua, New York. Licensed in New York. Registered with an NPI since 2005.

Licensed in
NY
In the registry since
2005
Specialties on file
6
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Practice location Address checks out

3019 County Complex Dr
Canandaigua, NY 14424-9505
Phone: (585) 396-4363
Fax: (585) 396-4993
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence 6879100A (NY)
Psychologist Taxonomy 103T00000X · Licence 6879100A (NY)
Clinical Psychologist Taxonomy 103TC0700X · Licence 6879100A (NY)
Clinical Social Worker Taxonomy 1041C0700X · Licence 6879100A (NY)
Psychiatry Physician Taxonomy 2084P0800X · Licence 6879100A (NY)
Nurse Practitioner Taxonomy 363L00000X · Licence 6879100A (NY)

Record details

NPI number1003802190
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jessica Mitchell — Director · (585) 396-4363
NPI enumeratedSeptember 23, 2005
Last updated in NPPESApril 1, 2021
Certification dateApril 1, 2021
Mailing address3019 County Complex Dr, Canandaigua, NY 14424-9505

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