Provider Demographics
NPI:1518074186
Name:MARINACCIO, BRIDGET C (PHD, LMHC NBCC)
Entity Type:Individual
Prefix:DR
First Name:BRIDGET
Middle Name:C
Last Name:MARINACCIO
Suffix:
Gender:F
Credentials:PHD, LMHC NBCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 BELMORE CT
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-1486
Mailing Address - Country:US
Mailing Address - Phone:716-949-0832
Mailing Address - Fax:
Practice Address - Street 1:50 BELMORE CT
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-1486
Practice Address - Country:US
Practice Address - Phone:716-949-0832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001506101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health