Active NPI
Cally Bucknell
- Addiction (Substance Use Disorder) Counselor
- Hurley, WI
National Provider Identifier
1174867170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 15674-132
- Practice address
- 300 Taconite St
Suite 201
Hurley, WI 54534-1546 - Phone
- (715) 561-3636
- NPI assigned
- Nov 15, 2012
- Last updated
- Apr 6, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 15674-132 | WI | Primary |
Addresses
Primary practice location
300 Taconite St
Suite 201
Hurley, WI 54534-1546
Mailing address
300 Taconite St
Suite 201
Hurley, WI 54534-1546
Phone (715) 561-3636
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15674-132 | WI | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491436800000",
"number": "1174867170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 TACONITE ST",
"address_2": "SUITE 201",
"city": "HURLEY",
"state": "WI",
"postal_code": "545341546",
"telephone_number": "715-561-3636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 TACONITE ST",
"address_2": "SUITE 201",
"city": "HURLEY",
"state": "WI",
"postal_code": "545341546",
"telephone_number": "715-561-3636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKNELL",
"first_name": "CALLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-15",
"last_updated": "2017-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "15674-132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hurley, WI
- Aspirus Grand View Service Corporation (Aspirus Grand View Clinic DME)
- Aspirus Ironwood Hospital & Clinics, Inc. (Aspirus Hurley Clinic)
- Aspirus Ironwood Hospital & Clinics, Inc. (Aspirus Hurley Clinic)
- Chelsea Rose Benson
- Mark Wesley Bolen, MSE, LPC
- Laura Katherine Burt, PHARM. D.
- Center Life Health LLC
- County of Iron
- County of Iron
- County of Iron
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.