Provider Demographics
NPI:1245487057
Name:SCHEPART, KIM M (LCSW-R)
Entity type:Individual
Prefix:MS
First Name:KIM
Middle Name:M
Last Name:SCHEPART
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:KIM
Other - Middle Name:M
Other - Last Name:SCHEPART
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:254 FRANKLIN STREET
Mailing Address - Street 2:LAKE SHORE BEHAVIORAL HEALTH
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202
Mailing Address - Country:US
Mailing Address - Phone:716-842-0440
Mailing Address - Fax:716-842-4069
Practice Address - Street 1:951 NIAGARA ST LOWR WEST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14213-2116
Practice Address - Country:US
Practice Address - Phone:716-884-0700
Practice Address - Fax:716-884-0631
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-22
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1245487057Medicaid