Provider Demographics
NPI:1497090831
Name:MALESKI, KATHERINE KEATING (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:KEATING
Last Name:MALESKI
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 1:312 WOODBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-1517
Mailing Address - Country:US
Mailing Address - Phone:716-880-5689
Mailing Address - Fax:
Practice Address - Street 1:1416 SWEET HOME RD
Practice Address - Street 2:3
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14228-2784
Practice Address - Country:US
Practice Address - Phone:216-880-5689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-11
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0807451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH10496Medicaid