Provider Demographics
NPI:1407313174
Name:KUNTZ, ERICA MARIE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:MARIE
Last Name:KUNTZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202-1804
Mailing Address - Country:US
Mailing Address - Phone:716-842-2750
Mailing Address - Fax:716-842-0668
Practice Address - Street 1:330 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202-1804
Practice Address - Country:US
Practice Address - Phone:716-842-2750
Practice Address - Fax:716-842-0668
Is Sole Proprietor?:No
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0971691104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker