Healthcare Provider Details

I. General information

NPI: 1659521870
Provider Name (Legal Business Name): KRISTEN N SZALACH-CAVANAUGH BA, LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KRISTEN N SZALACH BA, LMT

II. Dates (important events)

Enumeration Date: 09/24/2008
Last Update Date: 03/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1384 UNION RD.
WEST SENECA NY
14224
US

IV. Provider business mailing address

1384 UNION RD.
WEST SENECA NY
14224
US

V. Phone/Fax

Practice location:
  • Phone: 716-863-6822
  • Fax:
Mailing address:
  • Phone: 716-863-6822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License Number27 027469
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: