Ernestina S Buck, PHD

Individual provider Active NPI Professional Counselor · Bisbee, AZ

NPI 1245544162 · NPPES record last updated Jan 16, 2020

Key facts

NPI
1245544162
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
LPC-1608 (AZ)
Practice address
33 Subway St
Bisbee, AZ 85603
Phone
(520) 227-3695
Fax
(855) 568-6439
NPI assigned
Aug 3, 2010
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Medical, P.C. Current
since Jan 1, 2024
Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

3571 Far West Blvd
Austin, TX 78731
Phone (512) 567-4737

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC-1608 AZ Yes

Addresses

Primary practice location

33 Subway St
Bisbee, AZ 85603

Mailing address

PO Box 4171
Bisbee, AZ 85603-4171
Phone (520) 227-3695

Other providers in Bisbee, AZ

All providers in Bisbee, AZ · Professional Counselor in Arizona

Sources for this page

Verify at the official NPI Registry.