Healthcare Provider Details

I. General information

NPI: 1659678498
Provider Name (Legal Business Name): AMANDA E BUCKNER LSCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2011
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 W MAIN ST
ARLINGTON KS
67514-9701
US

IV. Provider business mailing address

PO BOX 273
ARLINGTON KS
67514-0273
US

V. Phone/Fax

Practice location:
  • Phone: 620-931-8869
  • Fax: 855-514-2738
Mailing address:
  • Phone: 620-931-8869
  • Fax: 855-514-2738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4784
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: