Provider Demographics
NPI:1477708279
Name:BUFKIN, ANDEE LOREN (LPC)
Entity Type:Individual
Prefix:MS
First Name:ANDEE
Middle Name:LOREN
Last Name:BUFKIN
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 1:14510 W SHUMWAY DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-5814
Mailing Address - Country:US
Mailing Address - Phone:602-291-6258
Mailing Address - Fax:
Practice Address - Street 1:14510 W SHUMWAY DR
Practice Address - Street 2:SUITE 202
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-5814
Practice Address - Country:US
Practice Address - Phone:602-291-6258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-12756101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional