Melissa A Buck, MS/LPCC-S

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E.0008329SUPV Issued in OH

Practice address

3095 Kettering Blvd
Moraine, OH 45439-1983

Phone

(937) 258-4246

Fax

(937) 258-4261

NPI assigned

Nov 1, 2012

Last updated

Sep 16, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2004

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• South Community Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Moraine, OH
  • NPI 1427289818
  Medicare reassignment NPD
• South Community

  • Community/Behavioral Health Agency
  • Kettering, OH
  • NPI 1003211061
  NPD (past) Authorized official
• South Community Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Moraine, OH
  • NPI 1639128176
  NPD

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

{
    "created_epoch": "1351728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1205180908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3095 KETTERING BLVD",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391983",
            "telephone_number": "937-258-4246",
            "fax_number": "937-258-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3095 KETTERING BLVD",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391983",
            "telephone_number": "937-258-4246",
            "fax_number": "937-258-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "MELISSA",
        "middle_name": "A",
        "credential": "MS/LPCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-01",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.0008329SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shanice Alexandra Brown
• John Bruner, RPH
• Logan Bruno
• Margaret Ann Bruns, LSW
• Lauren Buchanan, MA, QMHS
• Kayla Bucknor, LSW
• Tisier Bukshul, COUNSELLOR TRAINEE
• Monica Burbank, LPCC-S
• Samantha Burbank
• Dana Marie Burgess, LPN

• Professional Counselor in Moraine, OH
• Providers in Moraine, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.