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General NPI Number Information
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NPI Number | 1114184710
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Entity Type | Individual
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Provider Name | CARRIE RICH LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/21/2008
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Last Update Date | 06/26/2015
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Provider Practice Location Address
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Address Line | 3297 BAILEY AVE
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City | BUFFALO
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State | NY
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Zip | 14215-1139
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Country | US
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Telephone | 716-833-3622
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Fax | 716-834-5447
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Provider Business Mailing Address
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Address Line | 3020 BAILEY AVE
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City | BUFFALO
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State | NY
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Zip | 14215-2814
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Country | US
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Telephone | 716-831-2700
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 082657-1
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License Number State | NY
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