Provider Demographics
NPI:1821161118
Name:PRZYNOSCH, JENNIFER ANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ANN
Last Name:PRZYNOSCH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1526 WALDEN AVENUE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-4985
Mailing Address - Country:US
Mailing Address - Phone:716-895-6700
Mailing Address - Fax:716-332-4488
Practice Address - Street 1:1526 WALDEN AVENUE
Practice Address - Street 2:SUITE 400
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-4985
Practice Address - Country:US
Practice Address - Phone:716-895-6700
Practice Address - Fax:716-332-4488
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0694881041C0700X
NY0761011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical