Alex Samuel Buckner, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P07164 Issued in NY

Practice address

244 Hoyt St Apt 4R
Brooklyn, NY 11217-2999

Phone

(914) 329-0567

NPI assigned

Jul 28, 2017

Last updated

Jul 12, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Brooklyn Psychology, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1538906979
  NPD Authorized official
• Center for Personal Growth & Wellness LLC

  dba CPGW

  • Psychologist
  • New York, NY
  • NPI 1851732713

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1501200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1225552573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 HOYT ST APT 4R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112172999",
            "telephone_number": "914-329-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 HOYT ST APT 4R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112172999",
            "telephone_number": "914-329-0567"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8900 Van Wyck Expy",
            "address_purpose": "LOCATION",
            "city": "Richmond Hill",
            "state": "NY",
            "postal_code": "114182832",
            "country_code": "US",
            "telephone_number": "718-206-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "352 7th Ave Rm 801",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100015655",
            "country_code": "US",
            "telephone_number": "646-418-1172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCKNER",
        "first_name": "ALEX",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-28",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "022751-01",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "P07164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miracle Buckley, OTR
• Tamara R Buckley, PH.D.
• Deirdre Buckman, LMSW
• Allisa Ivorry Buckmire, LPN
• Bucknell Pharmacy Inc
• Cary D Buckner
• Natassia Buckridge, MD
• Jane F Buckwalter, LCSW
• Jose Hayag Buco, PT
• Emigdio A Bucobo, MD

• Clinical Psychologist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; 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.