Healthcare Provider Details

I. General information

NPI: 1053561647
Provider Name (Legal Business Name): JAMES GARBER LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2008
Last Update Date: 05/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7908 ALLEGHANY RD.
CORFU NY
14036
US

IV. Provider business mailing address

430 EAST MAIN ST.
BATAVIA NY
14020
US

V. Phone/Fax

Practice location:
  • Phone: 585-762-6000
  • Fax: 585-762-6001
Mailing address:
  • Phone: 585-343-1124
  • Fax: 585-343-1197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number080190-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: