Provider Demographics
NPI:1275420275
Name:D'AVIRRO, KATIE ANNE (LMHC)
Entity type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:ANNE
Last Name:D'AVIRRO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MS
Other - First Name:KATIE
Other - Middle Name:ANNE
Other - Last Name:MCCOULF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:124 GRAYTON RD
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-9032
Mailing Address - Country:US
Mailing Address - Phone:716-308-0118
Mailing Address - Fax:
Practice Address - Street 1:636 N FRENCH RD STE 7
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-1900
Practice Address - Country:US
Practice Address - Phone:716-308-0118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2664674101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health