Jacob Andrew Abraham

Individual provider Active NPI Mental Health Counselor · Buffalo, NY

NPI 1003589433 · NPPES record last updated Jul 30, 2021

Key facts

NPI
1003589433
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
P105172 (NY)
Practice address
387 Franklin St
Buffalo, NY 14202-1507
Phone
(716) 462-0284
Fax
(716) 262-0481
NPI assigned
Jul 30, 2021
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
P105172NYMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X P105172 NY Yes

Addresses

Primary practice location

387 Franklin St
Buffalo, NY 14202-1507

Mailing address

102 Cumberland Ave
Buffalo, NY 14220-1310
Phone (716) 931-0141

Other providers in Buffalo, NY

All providers in Buffalo, NY · Mental Health Counselor in New York

Sources for this page

Verify at the official NPI Registry.