Provider Demographics
NPI:1588282990
Name:BUCKLEY, LUCY (LCSW)
Entity type:Individual
Prefix:
First Name:LUCY
Middle Name:
Last Name:BUCKLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 CRYSTAL LN
Mailing Address - Street 2:
Mailing Address - City:EVINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24550-3733
Mailing Address - Country:US
Mailing Address - Phone:434-319-0139
Mailing Address - Fax:
Practice Address - Street 1:11 CRYSTAL LN
Practice Address - Street 2:
Practice Address - City:EVINGTON
Practice Address - State:VA
Practice Address - Zip Code:24550-3733
Practice Address - Country:US
Practice Address - Phone:434-319-0139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-13
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040080201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical