Basic Information
Provider Information
NPI: 1942306691
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PIASECZNY
FirstName: RONALD
MiddleName: ZENON
NamePrefix: MR.
NameSuffix:  
Credential: LMHC,CRC,CASAC-T,JD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 34 N MAIN ST
Address2:  
City: WARSAW
State: NY
PostalCode: 145691326
CountryCode: US
TelephoneNumber: 5857860220
FaxNumber: 5857863631
Practice Location
Address1: 227 THORN AVE
Address2:  
City: ORCHARD PARK
State: NY
PostalCode: 141272600
CountryCode: US
TelephoneNumber: 7166622040
FaxNumber: 7166620019
Other Information
ProviderEnumerationDate: 09/16/2006
LastUpdateDate: 12/13/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X004639NYY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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