Healthcare Provider Details

I. General information

NPI: 1083657191
Provider Name (Legal Business Name): JUDY MCCAFFERY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5330 MAIN ST STE 240
WILLIAMSVILLE NY
14221-5360
US

IV. Provider business mailing address

8047 MARBLE RD
AKRON NY
14001-9212
US

V. Phone/Fax

Practice location:
  • Phone: 716-626-9016
  • Fax:
Mailing address:
  • Phone: 585-542-3931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number068469
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: