Healthcare Provider Details

I. General information

NPI: 1811448244
Provider Name (Legal Business Name): KRISTIN GELIA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2016
Last Update Date: 11/08/2022
Certification Date: 11/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1412 SWEET HOME RD
AMHERST NY
14228-2795
US

IV. Provider business mailing address

741 DELAWARE AVE
BUFFALO NY
14209-2201
US

V. Phone/Fax

Practice location:
  • Phone: 716-589-1411
  • Fax: 716-276-3051
Mailing address:
  • Phone: 716-218-1450
  • Fax: 716-332-2820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number093585-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: