Provider Demographics
NPI:1891283834
Name:GARNCAREK, JUDITH (LISW)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:GARNCAREK
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 DALE DR
Mailing Address - Street 2:
Mailing Address - City:CASSADAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14718-9684
Mailing Address - Country:US
Mailing Address - Phone:330-671-7099
Mailing Address - Fax:
Practice Address - Street 1:182 DALE DR
Practice Address - Street 2:
Practice Address - City:CASSADAGA
Practice Address - State:NY
Practice Address - Zip Code:14718-9684
Practice Address - Country:US
Practice Address - Phone:330-671-7099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-25
Last Update Date:2025-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.20021731041C0700X
I.20021731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical