Provider Demographics
NPI:1295083392
Name:BUCKLEY, MAE RAMONA (MSW)
Entity type:Individual
Prefix:
First Name:MAE
Middle Name:RAMONA
Last Name:BUCKLEY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:DORI
Other - Middle Name:MICHELL
Other - Last Name:GARDNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:711 MONTCLAIR ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-2853
Mailing Address - Country:US
Mailing Address - Phone:412-576-3034
Mailing Address - Fax:
Practice Address - Street 1:712 SOUTH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-2940
Practice Address - Country:US
Practice Address - Phone:412-243-3401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-21
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health