Healthcare Provider Details

I. General information

NPI: 1841549094
Provider Name (Legal Business Name): EMILY JASKIER LCSW-R
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2012
Last Update Date: 03/17/2022
Certification Date: 03/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 W HUMBOLDT PKWY
BUFFALO NY
14214-2604
US

IV. Provider business mailing address

3176 ABBOTT RD UNIT A SUITE 500
ORCHARD PARK NY
14127-1069
US

V. Phone/Fax

Practice location:
  • Phone: 716-710-5151
  • Fax: 716-883-0687
Mailing address:
  • Phone: 716-822-2177
  • Fax: 716-822-8165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: