Healthcare Provider Details

I. General information

NPI: 1639216294
Provider Name (Legal Business Name): MARCIA E BUHL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 12/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 W UTICA ST
BUFFALO NY
14222-2017
US

IV. Provider business mailing address

352 ASHLAND AVE
BUFFALO NY
14222-1767
US

V. Phone/Fax

Practice location:
  • Phone: 716-884-7569
  • Fax: 716-884-4087
Mailing address:
  • Phone: 716-884-5403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberPRO15055-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: