Provider Demographics
NPI: | 1982682407 |
---|---|
Name: | HONESS-ONDREY, SALI (LCSW) |
Entity type: | Individual |
Prefix: | MS |
First Name: | SALI |
Middle Name: | |
Last Name: | HONESS-ONDREY |
Suffix: | |
Gender: | F |
Credentials: | LCSW |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 2130 S MAPLE AVE |
Mailing Address - Street 2: | P O BOX 444 |
Mailing Address - City: | ASHVILLE |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 14710-9604 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 716-763-0830 |
Mailing Address - Fax: | 716-763-0830 |
Practice Address - Street 1: | 2130 S MAPLE AVE |
Practice Address - Street 2: | |
Practice Address - City: | ASHVILLE |
Practice Address - State: | NY |
Practice Address - Zip Code: | 14710-9604 |
Practice Address - Country: | US |
Practice Address - Phone: | 716-763-0830 |
Practice Address - Fax: | 716-763-0830 |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2006-01-04 |
Last Update Date: | 2007-07-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | 038528-1 | 104100000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 104100000X | Behavioral Health & Social Service Providers | Social Worker |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NY | 00052300001 | Other | UNIVERA HEALTHCARE |
NY | 02274537 | Medicaid | |
NY | 6211160 | Other | INDEPENDENT HEALTH |
NY | 11515160 | Other | CAQH |
NY | 000526151001 | Other | BLUE CROSS/BLUE SHIELD |