MEDICARE: LAUREN BUCKLEY MA, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	178.020972	IL

General Provider Information

NPI Number	:	1346131885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN BUCKLEY MA, LPC

Provider Business Mailing Address
First Line	:	1919 S HIGHLAND AVE STE 325A
Second Line	:
City	:	LOMBARD
State	:	IL
Zip	:	60148-6181
Country	:	US
Telephone Number	:	630-613-8176
Fax Number	:

Provider Business Practice Location Address
First Line	:	1919 S HIGHLAND AVE STE 325A
Second Line	:
City	:	LOMBARD
State	:	IL
Zip	:	60148-6181
Country	:	US
Telephone Number	:	630-613-8176
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2025
Last Update Date	:	07/12/2025

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