Provider Demographics
NPI:1417727686
Name:TRABERT, AMY (DSW, LMSW)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:
Last Name:TRABERT
Suffix:
Gender:F
Credentials:DSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3959 N BUFFALO ST
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1841
Mailing Address - Country:US
Mailing Address - Phone:607-400-8601
Mailing Address - Fax:
Practice Address - Street 1:3959 N BUFFALO ST
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1841
Practice Address - Country:US
Practice Address - Phone:607-400-8601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY105534104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker