Provider Demographics
NPI:1659678498
Name:BUCKNER, AMANDA E (LMSW)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:E
Last Name:BUCKNER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 273
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67514-0273
Mailing Address - Country:US
Mailing Address - Phone:620-931-8869
Mailing Address - Fax:855-514-2738
Practice Address - Street 1:113 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:KS
Practice Address - Zip Code:67514-9701
Practice Address - Country:US
Practice Address - Phone:620-931-8869
Practice Address - Fax:855-514-2738
Is Sole Proprietor?:No
Enumeration Date:2011-02-14
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS7743OtherLMSW LICENSE