Provider Demographics
NPI:1972574473
Name:MESSER, DREW CARLSON (JD PHD)
Entity type:Individual
Prefix:DR
First Name:DREW
Middle Name:CARLSON
Last Name:MESSER
Suffix:
Gender:M
Credentials:JD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8616 MAIN STREET STE. 4
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221
Mailing Address - Country:US
Mailing Address - Phone:716-961-9435
Mailing Address - Fax:716-961-9436
Practice Address - Street 1:8616 MAIN STREET STE 4
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221
Practice Address - Country:US
Practice Address - Phone:716-961-9435
Practice Address - Fax:716-961-9436
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT048-0000679103TA0400X, 103TF0200X
IL071-005496103TC0700X
NY016499103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic