Healthcare Provider Details

I. General information

NPI: 1972526481
Provider Name (Legal Business Name): HARRY M BARSUK ED.D., LMHC, NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 09/28/2021
Certification Date: 09/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3384 W MAIN STREET RD
BATAVIA NY
14020-9458
US

IV. Provider business mailing address

3384 W MAIN STREET RD
BATAVIA NY
14020-9458
US

V. Phone/Fax

Practice location:
  • Phone: 716-560-0868
  • Fax:
Mailing address:
  • Phone: 716-560-0868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number000928-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: