Healthcare Provider Details

I. General information

NPI: 1912776477
Provider Name (Legal Business Name): CARMALETTA KAYE ZANDI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2023
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 GENESEE ST
LOCKPORT NY
14094-4424
US

IV. Provider business mailing address

140 GENESEE ST
LOCKPORT NY
14094-4424
US

V. Phone/Fax

Practice location:
  • Phone: 716-842-1300
  • Fax: 716-249-3388
Mailing address:
  • Phone: 716-842-1300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number904020271
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC020312
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801121914
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLICSW1143776
License Number StateMA
# 7
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.030892
License Number StateIL
# 8
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16886
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: