Provider Demographics
NPI:1720575731
Name:MAHER, MICHAEL T (LCSW)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:T
Last Name:MAHER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:199 PARK CLUB LN
Mailing Address - Street 2:STE 500
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5269
Mailing Address - Country:US
Mailing Address - Phone:716-845-1300
Mailing Address - Fax:716-856-2608
Practice Address - Street 1:6000 BROCKTON DR
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-9273
Practice Address - Country:US
Practice Address - Phone:716-845-3400
Practice Address - Fax:716-438-1430
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY097018-1104100000X
NY0940121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker