Organization
BRIGHTSIDE LCSW SERVICES, PLLC
Active
Organization
BRIGHTSIDE LCSW SERVICES, PLLC
Active
Other names
Brightside Counseling Services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHARMAINE ANN FANARA LCSWR (OWNER)
(716) 783-0407
Entity
Organization
Contact information
Practice address
40 GARDENVILLE PKWY STE 213, WEST SENECA, NY 14224-1399
(716) 783-0407
(716) 393-3430
Mailing address
59 ALYS DR E, DEPEW, NY 14043-1402
(716) 783-0407
(716) 393-3430
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
071265-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05054586
—
NY
Enumeration date
04/29/2011
Last updated
04/18/2022
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