Individual provider Active NPI

Wendy Janine Gottlieb-Sass, LCSW-R

  • Mental Health Counselor
  • Buffalo, NY
National Provider Identifier
1265582639
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
R030061-1 Issued in NY
Practice address
406 Linwood Ave
Buffalo, NY 14209-1629
Phone
(716) 886-7304
Fax
(716) 886-7398
NPI assigned
Jan 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X R030061-1 NY Primary

Addresses

Primary practice location

406 Linwood Ave
Buffalo, NY 14209-1629

Mailing address

103 Pin Oak Dr
Williamsville, NY 14221-1532
Phone (716) 636-6907

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
I20171116000430 NY Practitioner - Clinical Social Worker 4183980642 Practice locations: Buffalo, NY; Williamsville, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

406 Linwood Ave
Buffalo, NY 14209-1629
Phone (716) 886-7304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R030061-1NYMDMental Health Counselor
030061NYMDGeriatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265582639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 PIN OAK DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142211532",
            "telephone_number": "716-636-6907",
            "fax_number": "716-886-7398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 LINWOOD AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142091629",
            "telephone_number": "716-886-7304",
            "fax_number": "716-886-7398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTLIEB-SASS",
        "first_name": "WENDY",
        "middle_name": "JANINE",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "R030061-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.