Provider Demographics
NPI:1285965285
Name:WORK, KENNETH JAMES (LCSW-R)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:JAMES
Last Name:WORK
Suffix:
Gender:M
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8171 MAIN ST
Mailing Address - Street 2:#4
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-6024
Mailing Address - Country:US
Mailing Address - Phone:716-632-0070
Mailing Address - Fax:716-632-0078
Practice Address - Street 1:8171 MAIN ST
Practice Address - Street 2:#4
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-6024
Practice Address - Country:US
Practice Address - Phone:716-632-0070
Practice Address - Fax:716-632-0078
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-15
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR072693-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical