Provider Demographics
NPI:1316155906
Name:BUCKNER, ALEXANDRA (MSW, PSYCHOANALYST)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:BUCKNER
Suffix:
Gender:F
Credentials:MSW, PSYCHOANALYST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2915 38TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-5402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2166 WISCONSIN AVE NW
Practice Address - Street 2:SUITE B
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2280
Practice Address - Country:US
Practice Address - Phone:202-338-0007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNA102L00000X
DCLC3012491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical