Provider Demographics
NPI:1689948036
Name:BONCZYK, LINDA A (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:A
Last Name:BONCZYK
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6265 SHERIDAN DR
Mailing Address - Street 2:SUITE 122
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4833
Mailing Address - Country:US
Mailing Address - Phone:716-204-5552
Mailing Address - Fax:716-204-5557
Practice Address - Street 1:6265 SHERIDAN DR
Practice Address - Street 2:SUITE 122
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-4833
Practice Address - Country:US
Practice Address - Phone:716-204-5552
Practice Address - Fax:716-204-5557
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-02
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005002-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health