Provider Demographics
NPI:1255497954
Name:BUIKA, RICHARD CHARLES (LMFT,LADC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:CHARLES
Last Name:BUIKA
Suffix:
Gender:M
Credentials:LMFT,LADC
Other - Prefix:MR
Other - First Name:RICHARD
Other - Middle Name:CHARLES
Other - Last Name:BUIKA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:186 MAPLE HILL AVE
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-2723
Mailing Address - Country:US
Mailing Address - Phone:860-666-4786
Mailing Address - Fax:
Practice Address - Street 1:186 MAPLE HILL AVE
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111
Practice Address - Country:US
Practice Address - Phone:860-666-4786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000926106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist