Healthcare Provider Details

I. General information

NPI: 1891251997
Provider Name (Legal Business Name): NOELLE FLYNT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2019
Last Update Date: 07/03/2023
Certification Date: 07/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1416 SWEET HOME RD STE 1
AMHERST NY
14228-2786
US

IV. Provider business mailing address

1416 SWEET HOME RD STE 1
AMHERST NY
14228-2786
US

V. Phone/Fax

Practice location:
  • Phone: 716-249-1686
  • Fax:
Mailing address:
  • Phone: 716-249-1686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number107087
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number095471
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: