| Kelly Dumas, Lcsw, Pllc | |
|
3620 Harlem Rd Ste 15 Buffalo NY 14215-2042 | |
| (716) 936-7556 | |
| (716) 204-7750 |
| Full Name | Kelly Dumas, Lcsw, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 3620 Harlem Rd Ste 15, Buffalo, New York |
| Authorized Official Name and Position | Kelly Denise Dumas (OWNER) |
| Authorized Official Contact | 7169073344 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Dumas, Lcsw, Pllc 3620 Harlem Rd Ste 15 Buffalo NY 14215-2042 Ph: (716) 936-7556 | Kelly Dumas, Lcsw, Pllc 3620 Harlem Rd Ste 15 Buffalo NY 14215-2042 Ph: (716) 936-7556 |
| NPI Number | 1710744800 |
|---|---|
| Provider Enumeration Date | 03/05/2024 |
| Last Update Date | 02/07/2025 |
| Certification Date | 02/07/2025 |
| Medicare PECOS PAC ID | 4981149499 |
|---|---|
| Medicare Enrollment ID | O20240709002324 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710744800 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kelly D Dumas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356632756 PECOS PAC ID: 2860711405 Enrollment ID: I20150504002124 |
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