Provider Demographics
NPI:1407452154
Name:DIGBY, JERONICA (MA, LMHC, CASAC)
Entity Type:Individual
Prefix:MRS
First Name:JERONICA
Middle Name:
Last Name:DIGBY
Suffix:
Gender:F
Credentials:MA, LMHC, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 CHRISTA ST
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-2315
Mailing Address - Country:US
Mailing Address - Phone:716-935-8007
Mailing Address - Fax:
Practice Address - Street 1:17 CHRISTA ST
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-2315
Practice Address - Country:US
Practice Address - Phone:716-935-8007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-08
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY25968101YA0400X
NY010730101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY25968OtherCASAC
NY010730OtherLMHC