Healthcare Provider Details

I. General information

NPI: 1669361341
Provider Name (Legal Business Name): KIMBERLEY M ZITTEL-BARR PH.D., LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2025
Last Update Date: 06/30/2025
Certification Date: 06/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MOBILE COUNSELING OF NEW YORK 14 LAFAYETTE SQUARE, SUITE 2300
BUFFALO NY
14203
US

IV. Provider business mailing address

164 HOOVER AVE
KENMORE NY
14217-2518
US

V. Phone/Fax

Practice location:
  • Phone: 716-491-9696
  • Fax:
Mailing address:
  • Phone: 716-491-9696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number049672
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number049672
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: