Provider Demographics
NPI:1629649249
Name:YELICH, ALLYSON RAE (MSW)
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:RAE
Last Name:YELICH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8203 MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-6051
Mailing Address - Country:US
Mailing Address - Phone:716-219-3636
Mailing Address - Fax:
Practice Address - Street 1:8203 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-6051
Practice Address - Country:US
Practice Address - Phone:716-219-3636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor