Provider Demographics
NPI:1841093903
Name:MACHARIE, KAYSHAWN (LMSW)
Entity type:Individual
Prefix:MR
First Name:KAYSHAWN
Middle Name:
Last Name:MACHARIE
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 DELAWARE AVE STE 124
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202-1051
Mailing Address - Country:US
Mailing Address - Phone:716-266-3724
Mailing Address - Fax:716-287-6682
Practice Address - Street 1:651 DELAWARE AVE STE 124
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202-1051
Practice Address - Country:US
Practice Address - Phone:716-266-3724
Practice Address - Fax:716-287-6682
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1269071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical