National Provider Identifier

Mariah Lynn Komenda, LCSW

Mariah Lynn Komenda, LCSW is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Fredonia, NY and a listed phone number of (716) 672-6117.

NPI 1770967804Fredonia, NYClinical Social Worker

Profile Overview

NPI
1770967804
Provider Type
Individual
Primary Specialty
Clinical Social Worker
Enumeration Date
July 18, 2015
Last Updated
April 15, 2022

Practice Location

  • 355 Central Ave
  • Fredonia, NY 14063-1132

Phone: (716) 672-6117

Mailing Address

  • 246 Waverly St
  • Springville, NY 14141-1060

Specialties

  • Clinical Social Worker (1041C0700X)
  • Social Worker (104100000X)
Full Record
NPI
1770967804
Entity Type
Individual
Last Name
Komenda
First Name
Mariah
Middle Name
Lynn
Credential
LCSW
Mailing Street Address
246 Waverly St
Mailing City
Springville
Mailing State
NY
Mailing ZIP Code
14141-1060
Mailing Country
US
Mailing Phone
(716) 353-2593
Practice Street Address
355 Central Ave
Practice City
Fredonia
Practice State
NY
Practice ZIP Code
14063-1132
Practice Country
US
Practice Phone
(716) 672-6117
Practice Fax
(716) 672-6120
Enumeration Date
July 18, 2015
Last Updated
April 15, 2022
Sex
Female
Sole Proprietor
No
Certification Date
February 07, 2022
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Clinical Social Worker (1041C0700X), Social Worker (104100000X)