Provider Demographics
NPI:1588350193
Name:BUCKLEY, LAUREN M (LPC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:M
Last Name:BUCKLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:396 DANBURY RD UNIT B
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-2024
Mailing Address - Country:US
Mailing Address - Phone:203-520-3076
Mailing Address - Fax:
Practice Address - Street 1:396 DANBURY RD UNIT B
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-2024
Practice Address - Country:US
Practice Address - Phone:203-520-3076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6091103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling