Basic Information
Provider Information
NPI: 1144772641
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KRZYKOWSKI
FirstName: ALYCIA
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: LMHC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 531 FARBERLAKES DRIVE
Address2: SUITE 201
City: WILLIAMSVILLE
State: NY
PostalCode: 14221
CountryCode: US
TelephoneNumber: 7166325450
FaxNumber:  
Practice Location
Address1: 531 FARBER LAKES DR
Address2: SUITE 201
City: WILLIAMSVILLE
State: NY
PostalCode: 142215773
CountryCode: US
TelephoneNumber: 7166325450
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/31/2016
LastUpdateDate: 10/31/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X007410-1NYY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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