Basic Information
| Provider Information | |||||||||
| NPI: | 1275910895 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KAUSNER | ||||||||
| FirstName: | BETH | ||||||||
| MiddleName: | |||||||||
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| Credential: | CSW | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | LENGVARSKY | ||||||||
| OtherFirstName: | BETH | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 301 CAYUGA RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | CHEEKTOWAGA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142251950 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168193420 | ||||||||
| FaxNumber: | 7168193430 | ||||||||
| Practice Location | |||||||||
| Address1: | 110 CAMPUS DR | ||||||||
| Address2: | |||||||||
| City: | BRADFORD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 167011982 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8143626535 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2015 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.