Provider Demographics
NPI:1295169555
Name:LOBUZZETTA, MINDI IDA (LMHC)
Entity type:Individual
Prefix:MRS
First Name:MINDI
Middle Name:IDA
Last Name:LOBUZZETTA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:MINDI
Other - Middle Name:IDA
Other - Last Name:MAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:244 VILLA AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14216-1309
Mailing Address - Country:US
Mailing Address - Phone:716-128-5717
Mailing Address - Fax:
Practice Address - Street 1:1416 SWEET HOME RD STE 1
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2786
Practice Address - Country:US
Practice Address - Phone:716-812-5717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-22
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
NY007722101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor