Healthcare Provider Details

I. General information

NPI: 1598285827
Provider Name (Legal Business Name): MICHELLE ATLEE DAVIS WORONOWSKI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE ATLEE DAVIS LCSW

II. Dates (important events)

Enumeration Date: 06/27/2017
Last Update Date: 11/16/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5130 E MAIN STREET RD STE 2
BATAVIA NY
14020-3444
US

IV. Provider business mailing address

145 HAWTHORNE AVE APT 2
BUFFALO NY
14223-3015
US

V. Phone/Fax

Practice location:
  • Phone: 585-344-1421
  • Fax:
Mailing address:
  • Phone: 716-990-3164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number091192
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: