Healthcare Provider Details

I. General information

NPI: 1437404605
Provider Name (Legal Business Name): JODIE MCCARTHY LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JODIE BONNAS

II. Dates (important events)

Enumeration Date: 07/13/2012
Last Update Date: 08/17/2025
Certification Date: 08/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4230 N BUFFALO RD STE 3
ORCHARD PARK NY
14127-2424
US

IV. Provider business mailing address

4230 N BUFFALO RD STE 3
ORCHARD PARK NY
14127-2424
US

V. Phone/Fax

Practice location:
  • Phone: 716-997-3831
  • Fax:
Mailing address:
  • Phone: 716-997-3831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number002392
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: