Provider Demographics
NPI:1558820142
Name:FARINACCI, LAURIE (LMSW)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:FARINACCI
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 1:183 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14222-1842
Mailing Address - Country:US
Mailing Address - Phone:716-390-5591
Mailing Address - Fax:
Practice Address - Street 1:183 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14222-1842
Practice Address - Country:US
Practice Address - Phone:716-390-5591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY092095-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker