Basic Information
Provider Information
NPI: 1770636599
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LESSER
FirstName: CHRISTIE
MiddleName: L
NamePrefix: MRS.
NameSuffix:  
Credential: LCSWR
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1526 WALDEN AVENUE
Address2: SUITE 400
City: CHEEKTOWAGA
State: NY
PostalCode: 142254985
CountryCode: US
TelephoneNumber: 7168957167
FaxNumber: 7163324488
Practice Location
Address1: 5360 GENESSEE STREET
Address2:  
City: BOWMANSVILLE
State: NY
PostalCode: 140261044
CountryCode: US
TelephoneNumber: 7166815077
FaxNumber: 7166815079
Other Information
ProviderEnumerationDate: 01/18/2007
LastUpdateDate: 12/15/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X072451-RNYY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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