Organization
ACADEMIC HEALTH PSYCHOLOGY ASSOCIATES, P.C.
Active
Organization
ACADEMIC HEALTH PSYCHOLOGY ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY MARK LACKNER PSY.D. (OWNER)
(716) 898-5671
Entity
Organization
Contact information
Practice address
462 GRIDER ST, ROOM G208, BUFFALO, NY 14215-3021
(716) 898-5671
(716) 898-3040
Mailing address
PO BOX 93, AMHERST, NY 14226-0093
(716) 898-5671
(716) 898-3040
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
012051-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00025302101
UNIVERA ID NUMBER
NY
01
—
000523299002
BLUE CROSS ID NUMBER
NY
01
—
6108856
IHA ID NUMBER
NY
01
—
DF1724
RR MEDICARE
NY
Enumeration date
03/12/2007
Last updated
08/22/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up