Provider Demographics
NPI:1679674998
Name:BUCKMAN, CAROLINE (MSW LCSW)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:BUCKMAN
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2605
Mailing Address - Country:US
Mailing Address - Phone:859-224-8060
Mailing Address - Fax:859-381-0424
Practice Address - Street 1:1008 S BROADWAY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2605
Practice Address - Country:US
Practice Address - Phone:859-224-8060
Practice Address - Fax:859-381-0424
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2008-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY03951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000008715OtherCHA
KY000000059726OtherBCBS
000000049201OtherBCBS
KY000000059726OtherBCBS