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General NPI Number Information
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NPI Number | 1174379622
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Entity Type | Organization
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Legal Business Name | BUCKNER PSYCHOTHERAPY, PLLC
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Dates
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Enumeration Date | 04/25/2024
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 10160 HIGHWAY 242 STE 8001008
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City | CONROE
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State | TX
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Zip | 77385-4379
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Country | US
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Telephone | 713-364-4380
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Fax |
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Provider Business Mailing Address
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Address Line | 10160 HIGHWAY 242 STE 8001008
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City | CONROE
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State | TX
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Zip | 77385-4379
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Country | US
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Telephone | 713-364-4380
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST/OWNER
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Name | KIMBERLEY BUCKNER-MANLEY
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Credential | LPC
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Telephone | 936-661-1519
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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