Healthcare Provider Details

I. General information

NPI: 1881746089
Provider Name (Legal Business Name): LISA UZAROWSKI LCSW-R
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E MAIN ST
BATAVIA NY
14020-2200
US

IV. Provider business mailing address

200 E MAIN ST
BATAVIA NY
14020-2200
US

V. Phone/Fax

Practice location:
  • Phone: 585-344-0303
  • Fax:
Mailing address:
  • Phone: 585-344-0303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR057122-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: