Provider Demographics
NPI:1639357924
Name:BUCKLES, THOMAS J JR (LMHC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:BUCKLES
Suffix:JR
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2829 WEHRLE DR STE 6B
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-7387
Mailing Address - Country:US
Mailing Address - Phone:716-220-7496
Mailing Address - Fax:
Practice Address - Street 1:2829 WEHRLE DR STE 6B
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7387
Practice Address - Country:US
Practice Address - Phone:716-220-7496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-08
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005021101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health