National Provider Identifier

Jesse Grossman, LICENSED CLINICAL SO

Jesse Grossman, LICENSED CLINICAL SO is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Buffalo, NY and a listed phone number of (716) 816-2588.

NPI 1992291579Buffalo, NYClinical Social Worker

Profile Overview

NPI
1992291579
Provider Type
Individual
Primary Specialty
Clinical Social Worker
Enumeration Date
July 06, 2018
Last Updated
July 06, 2018

Practice Location

  • 400 Forest Avenue
  • Buffalo, NY 14213

Phone: (716) 816-2588

Specialties

  • Clinical Social Worker (1041C0700X)
Full Record
NPI
1992291579
Entity Type
Individual
Last Name
Grossman
First Name
Jesse
Credential
LICENSED CLINICAL SO
Mailing Street Address
400 Forest Avenue
Mailing City
Buffalo
Mailing State
NY
Mailing ZIP Code
14213
Mailing Country
US
Practice Street Address
400 Forest Avenue
Practice City
Buffalo
Practice State
NY
Practice ZIP Code
14213
Practice Country
US
Practice Phone
(716) 816-2588
Enumeration Date
July 06, 2018
Last Updated
July 06, 2018
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Clinical Social Worker (1041C0700X)