Provider Demographics
NPI:1700022332
Name:HEART COMMUNITY ALLIANCE
Entity Type:Organization
Organization Name:HEART COMMUNITY ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:AKMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAREEF
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R, CASAC, MSW
Authorized Official - Phone:716-834-0080
Mailing Address - Street 1:1131 KENSINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-1611
Mailing Address - Country:US
Mailing Address - Phone:716-834-0080
Mailing Address - Fax:716-834-0084
Practice Address - Street 1:1131 KENSINGTON AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-1611
Practice Address - Country:US
Practice Address - Phone:716-834-0080
Practice Address - Fax:716-834-0084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-03
Last Update Date:2009-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY73 069549101Y00000X, 101YA0400X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty