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General NPI Number Information
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NPI Number | 1386794006
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Entity Type | Individual
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Provider Name | VIVIAN KAREN GERARD NP, LCSWE AND RN
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Gender | Female
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 419 WALNUT AVE
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City | NIAGARA FALLS
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State | NY
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Zip | 14301-1761
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Country | US
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Telephone | 716-285-1904
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Fax | 716-284-8262
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Provider Business Mailing Address
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Address Line | 419 WALNUT AVE
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City | NIAGARA FALLS
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State | NY
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Zip | 14301-1761
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Country | US
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Telephone | 716-285-1904
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Fax | 716-284-8262
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | R0384571
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 3897821
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F401287-1
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License Number State | NY
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