Provider Demographics
NPI:1134588205
Name:MARASCO, ANGELA (LMHC-P)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:MARASCO
Suffix:
Gender:F
Credentials:LMHC-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 CAMPUS DR
Mailing Address - Street 2:4
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-3626
Mailing Address - Country:US
Mailing Address - Phone:716-553-2468
Mailing Address - Fax:
Practice Address - Street 1:1131 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14212-1501
Practice Address - Country:US
Practice Address - Phone:716-896-7350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-18
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health