Provider Demographics
NPI:1871184457
Name:BOCCHINO, EMMA ADELINE (LCSW, MFT)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:ADELINE
Last Name:BOCCHINO
Suffix:
Gender:F
Credentials:LCSW, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 CORPORATE WOODS STE 320
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-1466
Mailing Address - Country:US
Mailing Address - Phone:585-490-8380
Mailing Address - Fax:
Practice Address - Street 1:135 CORPORATE WOODS STE 320
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-1466
Practice Address - Country:US
Practice Address - Phone:585-490-8380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0978091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical