Provider Demographics
NPI:1679941223
Name:BUCKNUM, MARGARET LOUELLA (LCSW)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:LOUELLA
Last Name:BUCKNUM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 NW 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-3609
Mailing Address - Country:US
Mailing Address - Phone:503-291-1681
Mailing Address - Fax:503-445-0749
Practice Address - Street 1:2339 SE CLINTON ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-1234
Practice Address - Country:US
Practice Address - Phone:719-326-9381
Practice Address - Fax:971-326-9381
Is Sole Proprietor?:No
Enumeration Date:2015-09-11
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL7897101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health