Alice M Rosenthal, LICENSED CLINICAL SO

Individual provider Active NPI Clinical Social Worker · Snyder, NY

NPI 1891860896 · NPPES record last updated Jun 20, 2012

Key facts

NPI
1891860896
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
R023407 (NY)
Practice address
4511 Harlem Road
Suite 14
Snyder, NY 14226
Phone
(716) 833-2299
NPI assigned
Nov 22, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
R023407NYMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R023407 NY Yes

Addresses

Primary practice location

4511 Harlem Road
Suite 14
Snyder, NY 14226

Mailing address

249 Crosby Boulevard
Buffalo, NY 14226
Phone (716) 835-2955

Other identifiers

IdentifierTypeStateIssuer
000510980001OtherBLUE CR SHIELD OF WNY
6207982OtherUNIVERA AND INDEPENDENT H

Other providers in Snyder, NY

All providers in Snyder, NY · Clinical Social Worker in New York

Sources for this page

Verify at the official NPI Registry.