Provider Demographics
NPI:1184252066
Name:BUCKNER, JOHN CURTIS (LMFT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:CURTIS
Last Name:BUCKNER
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-3955
Mailing Address - Country:US
Mailing Address - Phone:435-592-6406
Mailing Address - Fax:
Practice Address - Street 1:427 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-3955
Practice Address - Country:US
Practice Address - Phone:435-592-6406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-28
Last Update Date:2020-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7448466-3902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist