Coleen Buckley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

103210 Issued in CA

Practice address

2178 Johnson Ave
San Luis Obispo, CA 93401-4535

Phone

(805) 781-4700

NPI assigned

Dec 17, 2015

Last updated

Oct 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1174988190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 693",
            "city": "MORRO BAY",
            "state": "CA",
            "postal_code": "934430693",
            "telephone_number": "805-748-9465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2178 JOHNSON AVE",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014535",
            "telephone_number": "805-781-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "COLEEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-17",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "103210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Brylewski, P.A.
• Brian S Buchanan, DC
• Jeanne Ann Buchanan, OT/L
• Louise Bryden Buck, M.D.
• Laura Lea Buckert, BSRN, PHN
• Lillian V. Bucton, L.C.S.W.
• Kailey Marie Buczek, PT, DPT
• Stephanie Buenafe, BCBA
• Gabriella Buitrago
• Courtney N. Bundren

• Clinical Social Worker in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.