Healthcare Provider Details
I. General information
NPI: 1114648722
Provider Name (Legal Business Name): LEANNE JEAN KAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/12/2022
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3176 ABBOTT RD STE 500
ORCHARD PARK NY
14127-1069
US
IV. Provider business mailing address
2101 SPRUCE ST
NORTH COLLINS NY
14111-9701
US
V. Phone/Fax
- Phone: 716-822-2117
- Fax: 716-822-8165
- Phone: 716-337-3706
- Fax: 716-337-2723
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: