Provider Demographics
NPI:1134947906
Name:KRNJAICH, VANESSA R (LMSW)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:R
Last Name:KRNJAICH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5205 MAIN ST.
Mailing Address - Street 2:SUITE 14
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221
Mailing Address - Country:US
Mailing Address - Phone:716-203-1096
Mailing Address - Fax:
Practice Address - Street 1:8205 MAIN ST STE 14
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-6054
Practice Address - Country:US
Practice Address - Phone:716-203-1096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY110335-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker