Provider Demographics
NPI:1477690303
Name:SAMEK, ERICA LEIGH (LCSW-R)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:LEIGH
Last Name:SAMEK
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HEALING LIVES FROM WITHIN
Mailing Address - Street 2:4200 SHEVA LANE
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-1315
Mailing Address - Country:US
Mailing Address - Phone:716-548-0383
Mailing Address - Fax:716-926-6252
Practice Address - Street 1:4200 SHEVA LANE
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-1315
Practice Address - Country:US
Practice Address - Phone:716-548-0383
Practice Address - Fax:716-926-6252
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0778491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03174036Medicaid
NYJ300097817Medicare Oscar/Certification