Provider Demographics
NPI:1598778474
Name:BUCKINGHAM, CHRISTINE ELIZABETH (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:ELIZABETH
Last Name:BUCKINGHAM
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3102 FLORAL PARK RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-9665
Mailing Address - Country:US
Mailing Address - Phone:301-292-2778
Mailing Address - Fax:301-292-0275
Practice Address - Street 1:3102 FLORAL PARK RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-9665
Practice Address - Country:US
Practice Address - Phone:301-292-2778
Practice Address - Fax:301-292-0275
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1984101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional