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NPI Code Detail

MEDICARE: SAMIRAH MAYFIELD CASAC-T

MEDICARE: SAMIRAH MAYFIELD CASAC-T
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
1101YA0400XAddiction (Substance Use Disorder) Counselor32908NY
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1366919680
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMIRAH MAYFIELD CASAC-T
Provider Business Mailing Address
First Line : 227 THORN AVE
Second Line :
City : ORCHARD PARK
State : NY
Zip : 14127-2600
Country : US
Telephone Number : 716-662-2040
Fax Number : 716-662-0019
Provider Business Practice Location Address
First Line : 1280 MAIN ST STE 3
Second Line :
City : BUFFALO
State : NY
Zip : 14209-1966
Country : US
Telephone Number : 716-832-1251
Fax Number : 716-832-1271
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2018
Last Update Date : 03/17/2023

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Directions to “ SAMIRAH MAYFIELD CASAC-T” Practice Location

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