Provider Demographics
NPI:1831307354
Name:MASSARO, ANTHONY (LMSW)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:
Last Name:MASSARO
Suffix:
Gender:M
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:PO BOX 55
Mailing Address - Street 2:
Mailing Address - City:RUSHFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14777-0055
Mailing Address - Country:US
Mailing Address - Phone:716-946-7968
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 55
Practice Address - Street 2:
Practice Address - City:RUSHFORD
Practice Address - State:NY
Practice Address - Zip Code:14777-0055
Practice Address - Country:US
Practice Address - Phone:716-946-7968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY066710104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker