Individual
MR. TODD SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CASAC-T
Contact information
Practice address
951 NIAGARA STREET, ADOLESCENT OUTPATIENT CHEMICAL DEPENDENCY PROGRAM, BUFFALO, NY 14213
(716) 883-5344
(716) 884-1758
Mailing address
254 FRANKLIN STREET, LAKE SHORE BEHAVIORAL HEALTH, BUFFALO, NY 14202
(716) 842-0440
(716) 842-4069
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20181
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20181
CASAC-T
NY
Enumeration date
03/03/2008
Last updated
03/03/2008
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