Provider Demographics
NPI:1881170678
Name:BUCZKOWSKI, ANGELINE MARIE (LPC)
Entity type:Individual
Prefix:
First Name:ANGELINE
Middle Name:MARIE
Last Name:BUCZKOWSKI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3807 LOGAN FERRY RD APT D6
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15239-2981
Mailing Address - Country:US
Mailing Address - Phone:412-609-7404
Mailing Address - Fax:
Practice Address - Street 1:100 EMERSON LN STE 1525
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-3484
Practice Address - Country:US
Practice Address - Phone:412-706-2554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-14
Last Update Date:2018-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010135101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor