National Provider Identifier
Edo George Vander Kooy, LCSW-R
Edo George Vander Kooy, LCSW-R is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Buffalo, NY and a listed phone number of (716) 838-1914.
Profile Overview
- NPI
- 1689981417
- Provider Type
- Individual
- Primary Specialty
- Clinical Social Worker
- Enumeration Date
- August 31, 2010
- Last Updated
- March 02, 2013
Practice Location
- 79 University Ave
- Buffalo, NY 14214-1224
Phone: (716) 838-1914
Specialties
- Clinical Social Worker (1041C0700X)
Full Record
- NPI
- 1689981417
- Entity Type
- Individual
- Last Name
- Vander Kooy
- First Name
- Edo
- Middle Name
- George
- Name Prefix
- Mr.
- Credential
- LCSW-R
- Mailing Street Address
- 79 University Ave
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14214-1224
- Mailing Country
- US
- Mailing Phone
- (716) 838-1914
- Mailing Fax
- (716) 282-2184
- Practice Street Address
- 79 University Ave
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14214-1224
- Practice Country
- US
- Practice Phone
- (716) 838-1914
- Practice Fax
- (716) 282-2184
- Enumeration Date
- August 31, 2010
- Last Updated
- March 02, 2013
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Clinical Social Worker (1041C0700X)
- Other Identifiers
- R020068 (NY, New York State Education Department - Licensed Clinical Social Worker)