Healthcare Provider Details
I. General information
NPI: 1942306691
Provider Name (Legal Business Name): RONALD ZENON PIASECZNY LMHC,CRC,CASAC-T,JD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/16/2006
Last Update Date: 12/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
227 THORN AVE
ORCHARD PARK NY
14127-2600
US
IV. Provider business mailing address
34 N MAIN ST
WARSAW NY
14569-1326
US
V. Phone/Fax
- Phone: 716-662-2040
- Fax: 716-662-0019
- Phone: 585-786-0220
- Fax: 585-786-3631
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 004639 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: