Provider Demographics
NPI:1538432562
Name:DIRR, ELIZABETH SALERNO (LCSW, CSSW)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:SALERNO
Last Name:DIRR
Suffix:
Gender:F
Credentials:LCSW, CSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 LAWN AVENUE
Mailing Address - Street 2:PFC. WILLIAM J. GRABIARZ CAMPUS #79
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14207-1517
Mailing Address - Country:US
Mailing Address - Phone:716-816-4040
Mailing Address - Fax:
Practice Address - Street 1:225 LAWN AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14207-1841
Practice Address - Country:US
Practice Address - Phone:716-816-4040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-22
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1155870211041S0200X
NY055671-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool