Healthcare Provider Details

I. General information

NPI: 1164575981
Provider Name (Legal Business Name): ADARA MARLENA ABERNETHY MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 WILLIAM ST
BUFFALO NY
14206-1649
US

IV. Provider business mailing address

1526 WALDEN AVE SUITE 400
CHEEKTOWAGA NY
14225-4965
US

V. Phone/Fax

Practice location:
  • Phone: 716-855-1384
  • Fax: 716-855-1386
Mailing address:
  • Phone: 716-895-7167
  • Fax: 716-332-4488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: