Healthcare Provider Details

I. General information

NPI: 1700258555
Provider Name (Legal Business Name): JACQUELINE MARY DENBESTE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JACQUELINE MARY SOLDI LMSW

II. Dates (important events)

Enumeration Date: 10/20/2015
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 FOREST AVE
BUFFALO NY
14213-1207
US

IV. Provider business mailing address

400 FOREST AVE
BUFFALO NY
14213-1207
US

V. Phone/Fax

Practice location:
  • Phone: 716-816-2256
  • Fax: 716-816-2076
Mailing address:
  • Phone: 716-816-2256
  • Fax: 716-816-2076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number104405
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: