NPIMap

Organization Active NPI

Lake Shore Behavioral Health

  • Clinic/Center
  • Buffalo, NY
National Provider Identifier
1346424520
Registry record updated Dec 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
02732658 Issued in NY
Legal business name
LAKE SHORE BEHAVIORAL HEALTH
Practice address
Lake Shore Behavioral Health
254 Franklin Street
Buffalo, NY 14202
Phone
(716) 842-0440
Fax
(716) 842-4069
NPI assigned
Dec 24, 2007
Last updated
Dec 24, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2007

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

Authorized official

Name
Dr. Howard Hitzel, PSY. D.
Title
President
Phone
(716) 842-0440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 02732658 NY Primary

Addresses

Primary practice location

Lake Shore Behavioral Health
254 Franklin Street
Buffalo, NY 14202

Mailing address

430 Niagara St
Buffalo, NY 14201-1886
Phone (716) 842-0440

Other identifiers 1

IdentifierTypeStateIssuer
MMIS#02732658OtherNYRISPERDAL CONSTA

National Provider Directory

National Provider Directory
Tax ID family
Lackawanna Counseling S12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1198454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198454400000",
    "number": "1346424520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 NIAGARA ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142011886",
            "telephone_number": "716-842-0440",
            "fax_number": "716-842-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LAKE SHORE BEHAVIORAL HEALTH",
            "address_2": "254 FRANKLIN STREET",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14202",
            "telephone_number": "716-842-0440",
            "fax_number": "716-842-4069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE SHORE BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-24",
        "last_updated": "2007-12-24",
        "status": "A",
        "authorized_official_last_name": "HITZEL",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "716-842-0440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY. D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "02732658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RISPERDAL CONSTA",
            "identifier": "MMIS#02732658",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.