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NPI Code Detail

MEDICARE: MISS MARY VICTORIA BUCKLEY MA, LPC

MEDICARE:  MISS MARY VICTORIA BUCKLEY  MA, LPC
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1912436346
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS MARY VICTORIA BUCKLEY MA, LPC
Provider Business Mailing Address
First Line : 1312 17TH ST # 1117
Second Line :
City : DENVER
State : CO
Zip : 80202-1508
Country : US
Telephone Number : 720-257-9972
Fax Number : 720-295-3931
Provider Business Practice Location Address
First Line : 1350 SPEER BLVD
Second Line :
City : DENVER
State : CO
Zip : 80204-2564
Country : US
Telephone Number : 720-257-9972
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2017
Last Update Date : 09/01/2021

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