Active NPI
Elizabeth Buckner, PH.D.
- Psychologist
- Wellesley, MA
National Provider Identifier
1316036437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6888
- Practice address
- 372 Washington St
Wellesley, MA 02481-6202 - Phone
- (781) 239-3550
- Fax
- (781) 239-3272
- NPI assigned
- Oct 12, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6888 | MA | Primary |
Addresses
Primary practice location
372 Washington St
Wellesley, MA 02481-6202
Mailing address
372 Washington St
Wellesley, MA 02481-6202
Phone (781) 239-3550
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W05625 | Other | MA | BCBSMA |
| 792461 | Other | MA | TUFTS HEALTH PLAN |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6888 | MA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316036437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "372 WASHINGTON ST",
"city": "WELLESLEY",
"state": "MA",
"postal_code": "024816202",
"telephone_number": "781-239-3550",
"fax_number": "781-239-3272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "372 WASHINGTON ST",
"city": "WELLESLEY",
"state": "MA",
"postal_code": "024816202",
"telephone_number": "781-239-3550",
"fax_number": "781-239-3272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKNER",
"first_name": "ELIZABETH",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "6888",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSMA",
"identifier": "W05625",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "792461",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wellesley, MA
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.