Conklin, Carol A

Conklin, Carol A is an sole proprietor health care provider with primary practice located at 610 Ashland Ave , Buffalo NY 14222-1309. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Conklin, Carol A can be contacted via phone (716) 883-7713.

Contact Information

Primary practice address
610 Ashland Ave Buffalo NY 14222-1309
Phone: (716) 883-7713
Fax: (716) 883-6718
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X R055959-1 New York

Profile Details

NPI number 1558338608
LBN Legal business name Conklin, Carol A
Credentials LCSW-R
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 7th, 2006
Last updated Oct 19th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558338608 NPPES
New York Other 00020965201 UNIVERA PROVIDER #
New York Other 000526017001 UNIVERA PROVIDER #
New York Other 161587546 UNIVERA PROVIDER #
New York Other 000526017002 UNIVERA PROVIDER #

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