Healthcare Provider Details

I. General information

NPI: 1588438451
Provider Name (Legal Business Name): AUTHENTICALLY WHOLE MENTAL HEALTH COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2023
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MAIN ST STE 5
LOCKPORT NY
14094-3606
US

IV. Provider business mailing address

1 MAIN ST STE 5
LOCKPORT NY
14094-3606
US

V. Phone/Fax

Practice location:
  • Phone: 716-944-6136
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DENIZ N WARNEY
Title or Position: OWNER
Credential: LMHC
Phone: 716-327-7457