Individual provider Active NPI

Bonny Jean-Cranford Buckley, M.A., LPC, NCC

  • Mental Health Counselor
  • High Point, NC
National Provider Identifier
1235278581
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC 4823 Issued in NC
Practice address
1124 E Lexington Ave
High Point, NC 27262-3336
Phone
(336) 841-6083
Fax
(336) 841-6330
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC 4823 NC Primary

Addresses

Primary practice location

1124 E Lexington Ave
High Point, NC 27262-3336

Mailing address

1124 E Lexington Ave
High Point, NC 27262-3336
Phone (336) 841-6083

Other identifiers 1

IdentifierTypeStateIssuer
6102416MedicaidNC

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LPC 4823NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Youth Focus Inc. Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235278581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 E LEXINGTON AVE",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272623336",
            "telephone_number": "336-841-6083",
            "fax_number": "336-841-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 E LEXINGTON AVE",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272623336",
            "telephone_number": "336-841-6083",
            "fax_number": "336-841-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "BONNY",
        "middle_name": "JEAN-CRANFORD",
        "credential": "M.A., LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "LPC 4823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102416",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.