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NPI Code Detail

MEDICARE: LEAH CATHERINE SHANAHAN LMSW

MEDICARE: LEAH CATHERINE SHANAHAN LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker125464NY

General Provider Information

NPI Number : 1205643830
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEAH CATHERINE SHANAHAN LMSW
Provider Business Mailing Address
First Line : 775 MAIN ST APT 202
Second Line :
City : BUFFALO
State : NY
Zip : 14203-1334
Country : US
Telephone Number : 716-256-9950
Fax Number :
Provider Business Practice Location Address
First Line : 1028 MAIN ST
Second Line :
City : BUFFALO
State : NY
Zip : 14202-1102
Country : US
Telephone Number : 716-859-5454
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2024
Last Update Date : 12/17/2024

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Directions to “ LEAH CATHERINE SHANAHAN LMSW” Practice Location

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