Provider Demographics
NPI:1972547792
Name:ALANCATKINSONPHDPSYCHOLOGISTPC
Entity type:Organization
Organization Name:ALANCATKINSONPHDPSYCHOLOGISTPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:ATKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:716-633-6863
Mailing Address - Street 1:5784 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5702
Mailing Address - Country:US
Mailing Address - Phone:716-633-6863
Mailing Address - Fax:716-633-9106
Practice Address - Street 1:5784 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5702
Practice Address - Country:US
Practice Address - Phone:716-633-6863
Practice Address - Fax:716-633-9106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7523-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00020550102OtherUNIVERA PROVIDER #
NY00020550102OtherUNIVERA PROVIDER #
NY00020550102OtherUNIVERA PROVIDER #