NPIMap

Organization Active NPI

Western New York Licensed Clinical Social Work Services, PLLC

Doing business as WNY LCSW Services PLLC

  • Clinical Social Worker
  • Williamsville, NY
National Provider Identifier
1316648710
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
WESTERN NEW YORK LICENSED CLINICAL SOCIAL WORK SERVICES, PLLC
Doing business as
WNY LCSW Services PLLC
Practice address
300 N. Forest Rd.
Ste #S256
Williamsville, NY 14221-5056
Phone
(716) 628-5296
NPI assigned
Mar 13, 2023
Last updated
Mar 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Authorized official

Name
Shirley B. Mazourek, LCSW-RNPI 1760545834
Title
Owner/Founder
Phone
(716) 628-5296

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary
Psychiatry Physician 2084P0800X NU

Addresses

Primary practice location

300 N. Forest Rd.
Ste #S256
Williamsville, NY 14221-5056

Mailing address

223 Cottonwood Drive
Williamsville, NY 14221-1608
Phone (716) 628-5296

Other names 1

  • WNY LCSW Services PLLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230421001079 NY Part B Supplier - Clinic/Group Practice 2365807542 Receives reassigned benefits from 1 practitioner
Practice locations: Buffalo, NY

National Provider Directory

National Provider Directory
Tax ID family
Western New York Licensed Clinical Social Work Services PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

77 Goodell St
Buffalo, NY 14203
Phone (716) 816-7258

300 N Forest Rd
Ste S256
Williamsville, NY 14221
Phone (716) 628-5296

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1316648710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 COTTONWOOD DRIVE",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142211608",
            "telephone_number": "716-628-5296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N. FOREST RD.",
            "address_2": "STE #S256",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215056",
            "telephone_number": "716-628-5296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN NEW YORK LICENSED CLINICAL SOCIAL WORK SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-13",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A",
        "authorized_official_last_name": "MAZOUREK",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "OWNER/FOUNDER",
        "authorized_official_telephone_number": "716-628-5296",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WNY LCSW Services PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.