Provider Demographics
NPI:1063915247
Name:BUCKSTINE, WILLIAM TOWNSEND (LCSW)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:TOWNSEND
Last Name:BUCKSTINE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21
Mailing Address - Street 2:
Mailing Address - City:HOLMES
Mailing Address - State:NY
Mailing Address - Zip Code:12531-0021
Mailing Address - Country:US
Mailing Address - Phone:914-224-6868
Mailing Address - Fax:
Practice Address - Street 1:333 ADAMS ST
Practice Address - Street 2:
Practice Address - City:BEDFORD HILLS
Practice Address - State:NY
Practice Address - Zip Code:10507-2001
Practice Address - Country:US
Practice Address - Phone:914-242-0708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0735741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical