Provider Demographics
NPI:1679722557
Name:TARTICK-CHUDY, JANET MARY (LCSW-R, CSSW)
Entity type:Individual
Prefix:MS
First Name:JANET
Middle Name:MARY
Last Name:TARTICK-CHUDY
Suffix:
Gender:F
Credentials:LCSW-R, CSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 COLVIN AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14216-1823
Mailing Address - Country:US
Mailing Address - Phone:716-877-5145
Mailing Address - Fax:
Practice Address - Street 1:449 COLVIN AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14216-1823
Practice Address - Country:US
Practice Address - Phone:716-877-5145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR035403-11041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool