Provider Demographics
NPI:1093729600
Name:STROMBERG, JOANNE REIDER (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:REIDER
Last Name:STROMBERG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 MAIN ST
Mailing Address - Street 2:SUITE 308
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-6755
Mailing Address - Country:US
Mailing Address - Phone:716-634-1184
Mailing Address - Fax:
Practice Address - Street 1:5500 MAIN ST
Practice Address - Street 2:SUITE 308
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-6755
Practice Address - Country:US
Practice Address - Phone:716-634-1184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR032461-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00053233001OtherUNIVERA HEALTH CARE
NY6211544OtherINDEPENDENT HEALTH ASSOC
NY000524178004OtherBLUE CROSS BLUE SHIELD
NY164234OtherCIGNA
NY6211544OtherINDEPENDENT HEALTH ASSOC
NYP83293Medicare UPIN