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NPI Code Detail

MEDICARE: SANCTUARY COUNSELING INC

MEDICARE: SANCTUARY COUNSELING INC
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 Worker

General Provider Information

NPI Number : 1437629250
Entity Type Code : Organization
Provider Name (Legal Business Name) : SANCTUARY COUNSELING INC
Provider Business Mailing Address
First Line : 238 SOUTHSIDE PKWY
Second Line :
City : BUFFALO
State : NY
Zip : 14220-1250
Country : US
Telephone Number : 716-361-6792
Fax Number :
Provider Business Practice Location Address
First Line : 381 KENMORE AVE
Second Line :
City : BUFFALO
State : NY
Zip : 14223-2861
Country : US
Telephone Number : 716-361-6792
Fax Number :
Authorized Official
Title or Position : OWNER/THERAPIST
Name : AARON J ROSENBAUM
Credential : LCSR-R
Telephone Number : 716-361-6792
Provider Enumeration Date : 12/05/2018
Last Update Date : 12/05/2018

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Directions to “SANCTUARY COUNSELING INC ” Practice Location

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