Provider Demographics
NPI:1629392899
Name:BUCKMAN, LINDSEY (PSYD)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:BUCKMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 E OSBORN RD
Mailing Address - Street 2:STE. 107
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-5217
Mailing Address - Country:US
Mailing Address - Phone:888-696-6798
Mailing Address - Fax:888-696-6798
Practice Address - Street 1:818 E OSBORN RD
Practice Address - Street 2:STE. 107
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-5217
Practice Address - Country:US
Practice Address - Phone:888-696-6798
Practice Address - Fax:888-696-6798
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4072103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical