Provider Demographics
NPI:1538142096
Name:BUCKLAND, LINDA G (LMHC CCMHC NCC)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:G
Last Name:BUCKLAND
Suffix:
Gender:F
Credentials:LMHC CCMHC NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 MOUNTAIN DRIVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541-2346
Mailing Address - Country:US
Mailing Address - Phone:850-837-9100
Mailing Address - Fax:850-837-3774
Practice Address - Street 1:215 MOUNTAIN DRIVE
Practice Address - Street 2:SUITE 106
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-2346
Practice Address - Country:US
Practice Address - Phone:850-837-9100
Practice Address - Fax:850-837-3774
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH2636101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ4661OtherB CROSS BLUE SHIELD
190789OtherVALUE OPTIONS
083451OtherMANAGED HEALTH NETWORK