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General NPI Number Information
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NPI Number | 1609086131
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Entity Type | Organization
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Legal Business Name | BUCKNER CHILDREN & FAMILY SERVICES
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 129 BRENTWOOD AVE
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City | LUBBOCK
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State | TX
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Zip | 79416-1601
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Country | US
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Telephone | 806-795-7151
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Fax | 806-795-9727
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Provider Business Mailing Address
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Address Line | 129 BRENTWOOD AVE
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City | LUBBOCK
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State | TX
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Zip | 79416-1601
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Country | US
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Telephone | 806-795-7151
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Fax | 806-795-9727
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | TOMMY SPEED
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Credential |
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Telephone | 806-795-7151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 19059
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License Number State | TX
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