Healthcare Provider Details

I. General information

NPI: 1801790753
Provider Name (Legal Business Name): BUCK PSYCHIATRIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 LOWELL ST
LEXINGTON MA
02420-2810
US

IV. Provider business mailing address

48 LOWELL ST
LEXINGTON MA
02420-2810
US

V. Phone/Fax

Practice location:
  • Phone: 617-297-7409
  • Fax:
Mailing address:
  • Phone: 617-297-7409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: EMILY BUCK
Title or Position: PMHNP
Credential:
Phone: 857-919-2704