Provider Demographics
NPI:1447445085
Name:SCHLOSS, EVAN (LMFT, LPCC)
Entity type:Individual
Prefix:
First Name:EVAN
Middle Name:
Last Name:SCHLOSS
Suffix:
Gender:M
Credentials:LMFT, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 VASSAR ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-3344
Mailing Address - Country:US
Mailing Address - Phone:585-210-8806
Mailing Address - Fax:
Practice Address - Street 1:237 VASSAR ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-3344
Practice Address - Country:US
Practice Address - Phone:585-210-8806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2021-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA747101YM0800X
CA49947106H00000X
NY001690106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health