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General NPI Number Information
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NPI Number | 1568601649
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Entity Type | Individual
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Provider Name | LINDA BARBARA BUCKLAEW LCSW, CEAP
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Gender | Female
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Dates
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Enumeration Date | 02/12/2009
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 4034 GEORGE WASHINGTON MEM HWY
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City | YORKTOWN
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State | VA
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Zip | 23692-2620
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Country | US
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Telephone | 757-598-2244
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Fax |
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Provider Business Mailing Address
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Address Line | 2202 EXECUTIVE DR STE C
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City | HAMPTON
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State | VA
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Zip | 23666-6604
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Country | US
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Telephone | 757-827-7707
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904005777
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License Number State | VA
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