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General NPI Number Information
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NPI Number | 1548772312
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Entity Type | Organization
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Legal Business Name | LORI BADACH,LCSW, PLLC
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Dates
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Enumeration Date | 11/01/2017
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Last Update Date | 11/01/2017
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Provider Practice Location Address
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Address Line | 2240 NORTH FOREST ROAD
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-1422
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Country | US
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Telephone | 716-331-0447
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Fax | 716-331-0447
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Provider Business Mailing Address
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Address Line | 59 WILLOWBROOK DR
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City | ORCHARD PARK
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State | NY
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Zip | 14127-4327
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Country | US
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Telephone | 716-308-7056
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | MRS. LORI LEE BADACH
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Credential | LCSW
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Telephone | 716-331-0447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | R071801-01
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License Number State | NY
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