Individual
PATRICK MACKENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC-T
Contact information
Practice address
425 MICHIGAN AVE, BUFFALO, NY 14203-2209
(716) 848-2000
(716) 848-2112
Mailing address
425 MICHIGAN AVE, BUFFALO, NY 14203-2209
(716) 848-2000
(716) 848-2112
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20011
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20011
CASAC-T
NY
Enumeration date
11/16/2006
Last updated
01/24/2011
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