Individual provider Active NPI

Kaylyn Bunz, LCSW, CASAC-T

  • Clinical Social Worker
  • Buffalo, NY
National Provider Identifier
1033731963
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089437-01 Issued in NY
Practice address
462 Grider St
Buffalo, NY 14215-3098
Phone
(716) 898-4918
NPI assigned
May 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 31549 NY
Clinical Social Worker 1041C0700X 089437-01 NY Primary

Addresses

Primary practice location

462 Grider St
Buffalo, NY 14215-3098

Mailing address

69 Meadowlawn Rd
Cheektowaga, NY 14225-3608
Phone (716) 225-0033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210503001405 NY Practitioner - Clinical Social Worker 9436568599 Practice locations: Tonawanda, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31549NYMDAddiction (Substance Use Disorder) Counselor
089437-01NYMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589414400000",
    "number": "1033731963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 MEADOWLAWN RD",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142253608",
            "telephone_number": "716-225-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 GRIDER ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142153098",
            "telephone_number": "716-898-4918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNZ",
        "first_name": "KAYLYN",
        "credential": "LCSW, CASAC-T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-14",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "31549",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "089437-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.