Active NPI
Ronni Buckler, LCSW
- Clinical Social Worker
- Berlin, MD
National Provider Identifier
1437187309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 11961
- Practice address
- 29 Broad St
Suite 203
Berlin, MD 21811-1052 - Phone
- (410) 641-4598
- Fax
- (410) 641-4696
- NPI assigned
- Jun 29, 2006
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 11961 | MD | Primary |
Addresses
Primary practice location
29 Broad St
Suite 203
Berlin, MD 21811-1052
Mailing address
29 Broad St
Suite 203
Berlin, MD 21811-1052
Phone (410) 641-4598
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 620713-02 | Other | MD | MD CAREFIRST BCBS |
| 2174438 | Other | MD | CIGNA |
| G934-0002 | Other | MD | NCA CAREFIRST BCBS |
| 4114355 | Other | MD | MAMSI |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11961 | MD | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Worcester Youth and Family Counseling Services, 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.
-
- Professional Counselor
- Berlin, MD
- NPI 1043254824
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1437187309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 BROAD ST",
"address_2": "SUITE 203",
"city": "BERLIN",
"state": "MD",
"postal_code": "218111052",
"telephone_number": "410-641-4598",
"fax_number": "410-641-4696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 BROAD ST",
"address_2": "SUITE 203",
"city": "BERLIN",
"state": "MD",
"postal_code": "218111052",
"telephone_number": "410-641-4598",
"fax_number": "410-641-4696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKLER",
"first_name": "RONNI",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "11961",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MD CAREFIRST BCBS",
"identifier": "620713-02",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2174438",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCA CAREFIRST BCBS",
"identifier": "G934-0002",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "4114355",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Berlin, MD
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.