Provider Demographics
NPI:1306619234
Name:OCD AND ANXIETY SERVICES, LLC
Entity type:Organization
Organization Name:OCD AND ANXIETY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:DAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCKETT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:262-202-8512
Mailing Address - Street 1:16535 W BLUEMOUND RD STE 321
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-5936
Mailing Address - Country:US
Mailing Address - Phone:262-202-8512
Mailing Address - Fax:
Practice Address - Street 1:16535 W BLUEMOUND RD STE 321
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-5936
Practice Address - Country:US
Practice Address - Phone:262-202-8512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty