National Provider Identifier
Brightside Lcsw Services, PLLC
Brightside Lcsw Services, PLLC is listed in the NPPES registry with a primary specialty of Clinical Social Worker in West Seneca, NY and a listed phone number of (716) 783-0407.
Source: public NPPES record, last updated April 18, 2022. This profile is informational and is not medical advice, a quality rating, or a provider recommendation.
Profile Overview
- NPI
- 1871884460
- Provider Type
- Organization
- Primary Specialty
- Clinical Social Worker
- Enumeration Date
- April 29, 2011
- Last Updated
- April 18, 2022
Practice Location
- 40 Gardenville Pkwy Ste 213
- West Seneca, NY 14224-1399
Phone: (716) 783-0407
Mailing Address
- 59 Alys Dr E
- Depew, NY 14043-1402
Authorized Official
- Name
- MS. Charmaine Ann Fanara
- Title
- Owner
- Credentials
- LCSWR
- Phone
- (716) 783-0407
Specialties
- Clinical Social Worker (1041C0700X)
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Full Record
- NPI
- 1871884460
- Entity Type
- Organization
- EIN
- <UNAVAIL>
- Organization Name
- Brightside Lcsw Services, PLLC
- Other Organization Name
- <Unavail>
- Provider Other Organization Name Type Code
- 6
- Mailing Street Address
- 59 Alys Dr E
- Mailing City
- Depew
- Mailing State
- NY
- Mailing ZIP Code
- 14043-1402
- Mailing Country
- US
- Mailing Phone
- (716) 783-0407
- Mailing Fax
- (716) 393-3430
- Practice Street Address
- 40 Gardenville Pkwy Ste 213
- Practice City
- West Seneca
- Practice State
- NY
- Practice ZIP Code
- 14224-1399
- Practice Country
- US
- Practice Phone
- (716) 783-0407
- Practice Fax
- (716) 393-3430
- Enumeration Date
- April 29, 2011
- Last Updated
- April 18, 2022
- Authorized Official Last Name
- Fanara
- Authorized Official First Name
- Charmaine
- Authorized Official Middle Name
- Ann
- Authorized Official Title
- Owner
- Authorized Official Phone
- (716) 783-0407
- Organization Subpart
- No
- Authorized Official Name Prefix Text
- MS.
- Authorized Official Credential Text
- LCSWR
- Taxonomy Group 1
- 193400000X Single Specialty Group
- Certification Date
- April 18, 2022
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Clinical Social Worker (1041C0700X)
- Other Identifiers
- 05054586 (NY)