Healthcare Provider Details

I. General information

NPI: 1609514611
Provider Name (Legal Business Name): SARAH KUCHARSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2022
Last Update Date: 09/06/2023
Certification Date: 09/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6350 MAIN ST
WILLIAMSVILLE NY
14221-5821
US

IV. Provider business mailing address

6350 MAIN ST
WILLIAMSVILLE NY
14221-5821
US

V. Phone/Fax

Practice location:
  • Phone: 716-783-3221
  • Fax: 716-633-7922
Mailing address:
  • Phone: 716-783-3221
  • Fax: 716-633-7922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: