Kimberly Ann Boronczyk

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

768 Delaware Ave
Buffalo, NY 14209-2006

Phone

(716) 882-3151

NPI assigned

Dec 22, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Liberty Resources Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Syracuse, NY
  • NPI 1225254881

  NY

  Medicare reassignment NPD
• Liberty Resources, Inc.

  • Substance Abuse Rehabilitation Facility
  • Syracuse, NY
  • NPI 1639729452
  NPD
• Liberty Resources, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fulton, NY
  • NPI 1700688827
  NPD

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

{
    "created_epoch": "1545436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1407328883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142021102",
            "telephone_number": "716-881-2405",
            "fax_number": "716-881-2425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "768 DELAWARE AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142092006",
            "telephone_number": "716-882-3151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Main St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142021102",
            "country_code": "US",
            "telephone_number": "716-881-2405",
            "fax_number": "716-881-2425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORONCZYK",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-22",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jillian Boris, NP
• Elizabeth Anne Bork, CRC, LMHS
• Abby Borkowski, DC
• Ashley Borland
• Suzanne Borodzik
• Shannon Rae Borow, LMSW
• Aaron Borowczyk, LMSW
• Samantha Borowczyk
• Drucy Sarette Borowitz, M.D.
• Aimee Sue Borrello

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.