Provider Demographics
NPI:1548312572
Name:JAIMES, CHRISTINE E (LCSW R)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:E
Last Name:JAIMES
Suffix:
Gender:F
Credentials:LCSW R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 BUCYRUS DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-1954
Mailing Address - Country:US
Mailing Address - Phone:716-359-3008
Mailing Address - Fax:
Practice Address - Street 1:1868 NIAGARA FALLS BLVD STE 306
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150-6494
Practice Address - Country:US
Practice Address - Phone:716-359-3008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0736461101YM0800X
NYR073646-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health