Provider Demographics
NPI:1336375054
Name:GIANCARLO, ADAM LOUIS (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:LOUIS
Last Name:GIANCARLO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:833 SAINT LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14216-1618
Mailing Address - Country:US
Mailing Address - Phone:716-296-0075
Mailing Address - Fax:716-874-4656
Practice Address - Street 1:4476 MAIN ST.
Practice Address - Street 2:SUITE #208
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-4665
Practice Address - Country:US
Practice Address - Phone:716-712-4576
Practice Address - Fax:585-786-3631
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-09
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0839441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical