Provider Demographics
NPI:1700025418
Name:PARADISO, MARY CATHERINE (NCC, LMHC, CASAC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:CATHERINE
Last Name:PARADISO
Suffix:
Gender:F
Credentials:NCC, LMHC, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 DODGE RD
Mailing Address - Street 2:
Mailing Address - City:GETZVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14068-1205
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2563 UNION RD
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14227-2275
Practice Address - Country:US
Practice Address - Phone:716-668-7622
Practice Address - Fax:716-668-7623
Is Sole Proprietor?:No
Enumeration Date:2009-02-19
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010551-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health