Provider Demographics
NPI:1376887083
Name:BUCKLER, JENNIFER BLAIR (MS, LPCA)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:BLAIR
Last Name:BUCKLER
Suffix:
Gender:F
Credentials:MS, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 HAW CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-1104
Mailing Address - Country:US
Mailing Address - Phone:404-290-3576
Mailing Address - Fax:
Practice Address - Street 1:41 HAW CREEK CIR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-1104
Practice Address - Country:US
Practice Address - Phone:404-290-3576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA9830101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health