Healthcare Provider Details

I. General information

NPI: 1346150711
Provider Name (Legal Business Name): QUEEN CITY MENTAL HEALTH COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 CAESAR BLVD
BUFFALO NY
14221-5904
US

IV. Provider business mailing address

148 CAESAR BLVD
BUFFALO NY
14221-5904
US

V. Phone/Fax

Practice location:
  • Phone: 716-427-5024
  • Fax:
Mailing address:
  • Phone: 716-427-5024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. AMBER JOHANNA ELSENBECK
Title or Position: OWNER & PRACTITIONER
Credential: LMHC-D
Phone: 716-868-0346