Provider Demographics
NPI:1750463634
Name:ORTIZ, MARIA M (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:M
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 HAMPSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14213-2017
Mailing Address - Country:US
Mailing Address - Phone:716-883-0659
Mailing Address - Fax:
Practice Address - Street 1:330 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202-1804
Practice Address - Country:US
Practice Address - Phone:171-842-2750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071857-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health