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General NPI Number Information
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NPI Number | 1144286071
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Entity Type | Individual
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Provider Name | TRACEY C. MIERS LCSW-R
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Gender | Female
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Dates
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Enumeration Date | 04/20/2006
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Last Update Date | 12/06/2011
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Provider Practice Location Address
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Address Line | 40 MAIN ST
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City | HAMBURG
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State | NY
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Zip | 14075-4948
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Country | US
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Telephone | 716-648-6515
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Fax | 716-648-7101
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Provider Business Mailing Address
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Address Line | 741 DELAWARE AVE
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City | BUFFALO
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State | NY
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Zip | 14209-2201
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Country | US
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Telephone | 716-218-1450
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Fax | 716-332-2820
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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 | 0000038174
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License Number State | NY
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