Provider Demographics
NPI:1851802292
Name:PSYCHOLOGICAL SERVICES OF WNY
Entity Type:Organization
Organization Name:PSYCHOLOGICAL SERVICES OF WNY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/OWNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:716-422-0054
Mailing Address - Street 1:84 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-4834
Mailing Address - Country:US
Mailing Address - Phone:716-422-0054
Mailing Address - Fax:
Practice Address - Street 1:84 LAKE ST
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-4834
Practice Address - Country:US
Practice Address - Phone:716-422-0054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-12
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022061103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty