Healthcare Provider Details

I. General information

NPI: 1174447213
Provider Name (Legal Business Name): COLLECTIVE FLOW STUDIO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 MAIN ST
WEST SENECA NY
14224-2731
US

IV. Provider business mailing address

233 MAIN ST
WEST SENECA NY
14224-2731
US

V. Phone/Fax

Practice location:
  • Phone: 716-444-7822
  • Fax:
Mailing address:
  • Phone: 716-444-7822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: BRIANNA MAREK
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 716-444-7822