Bobby J Buckaloo, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC5878 Issued in OK

Practice address

17200 McGahey Rd
Kingston, OK 73439-5530

Phone

(580) 564-6034

NPI assigned

Dec 16, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• BJ Buckaloo Professional name

Medicare fee-for-service enrollment

Enrolled in OK

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Elite Counseling LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kingston, OK
  • NPI 1144554585
  Medicare reassignment NPD

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

{
    "created_epoch": "1323993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1265701411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17200 MCGAHEY RD",
            "city": "KINGSTON",
            "state": "OK",
            "postal_code": "734395530",
            "telephone_number": "580-564-6034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17200 MCGAHEY RD",
            "city": "KINGSTON",
            "state": "OK",
            "postal_code": "734395530",
            "telephone_number": "580-564-6034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKALOO",
        "first_name": "BOBBY",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-16",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "LPC5878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BJ",
            "last_name": "BUCKALOO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Karen Sue Carr, M.A., LPC
• Meagan Carter
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• Chickasaw Nation
• Clinic at 410 PLLC

• Mental Health Counselor in Kingston, OK
• Providers in Kingston, OK by specialty
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; 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.