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NPI Code Detail

MEDICARE: MIKAELA BUCK LPCC-S

MEDICARE: MIKAELA BUCK LPCC-S
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorC.2002907-TRNE
2101YM0800XMental Health CounselorC.2204000OH
3101YP2500XProfessional CounselorE.2404205-SUPVOH

General Provider Information

NPI Number : 1790271054
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIKAELA BUCK LPCC-S
Provider Business Mailing Address
First Line : 4159 N HOLLAND SYLVANIA RD STE 205
Second Line :
City : TOLEDO
State : OH
Zip : 43623-4801
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4159 N HOLLAND SYLVANIA RD STE 205
Second Line :
City : TOLEDO
State : OH
Zip : 43623-4801
Country : US
Telephone Number : 419-517-6564
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2018
Last Update Date : 06/16/2025

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Directions to “ MIKAELA BUCK LPCC-S” Practice Location

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