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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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