National Provider Identifier

Stephanie L. I. Massara-Polyachenko, MHC-P

Stephanie L. I. Massara-Polyachenko, MHC-P is listed in the NPPES registry with a primary specialty of Mental Health Counselor in Buffalo, NY and a listed phone number of (716) 893-0062.

NPI 1154957561Buffalo, NYMental Health Counselor

Profile Overview

NPI
1154957561
Provider Type
Individual
Primary Specialty
Mental Health Counselor
Enumeration Date
March 17, 2020
Last Updated
March 17, 2020

Practice Location

  • 463 William St
  • Buffalo, NY 14204-1811

Phone: (716) 893-0062

Specialties

  • Mental Health Counselor (101YM0800X)
Full Record
NPI
1154957561
Entity Type
Individual
Last Name
Massara-Polyachenko
First Name
Stephanie
Middle Name
L. I.
Name Prefix
Mrs.
Credential
MHC-P
Provider Other Last Name
Massara-Polyachenko
Provider Other First Name
Stephanie
Provider Other Middle Name
L. I.
Provider Other Name Prefix Text
Miss
Provider Other Last Name Type Code
1
Mailing Street Address
463 William St
Mailing City
Buffalo
Mailing State
NY
Mailing ZIP Code
14204-1811
Mailing Country
US
Mailing Phone
(716) 893-0062
Practice Street Address
463 William St
Practice City
Buffalo
Practice State
NY
Practice ZIP Code
14204-1811
Practice Country
US
Practice Phone
(716) 893-0062
Enumeration Date
March 17, 2020
Last Updated
March 17, 2020
Sex
Female
Sole Proprietor
No
Certification Date
March 17, 2020
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Mental Health Counselor (101YM0800X)