Provider Demographics
NPI:1902783368
Name:MARY KRUSZKA, LCSW, PLLC
Entity type:Organization
Organization Name:MARY KRUSZKA, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:KAHTERINE
Authorized Official - Last Name:KRUSZKA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSWR
Authorized Official - Phone:716-698-7259
Mailing Address - Street 1:84 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-4859
Mailing Address - Country:US
Mailing Address - Phone:716-698-7259
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:14075-4859
Practice Address - Country:US
Practice Address - Phone:716-698-7259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health