NPIMap

Organization Active NPI

Buckelew Programs

  • Community/Behavioral Health Agency
  • Santa Rosa, CA
National Provider Identifier
1609644848
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
BUCKELEW PROGRAMS
Practice address
2235 Mercury Way Ste 107
Santa Rosa, CA 95407-5472
Phone
(707) 780-7239
NPI assigned
Dec 18, 2023
Last updated
Dec 18, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
BUCKELEW PROGRAMSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Authorized official

Name
John Christopher Kughn, LMFTNPI 1821012279
Title
Ceo
Phone
(415) 457-6966

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2235 Mercury Way Ste 107
Santa Rosa, CA 95407-5472

Mailing address

2235 Mercury Way Ste 107
Santa Rosa, CA 95407-5472
Phone (707) 780-7239

Other names 1

  • Buckelew Community Response Team Other name

National Provider Directory

National Provider Directory
Tax ID family
Buckelew Programs13 organizations share this tax ID, including this one
Part of
Buckelew Programs

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702857600000",
    "number": "1609644848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 MERCURY WAY STE 107",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954075472",
            "telephone_number": "707-780-7239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 MERCURY WAY STE 107",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954075472",
            "telephone_number": "707-780-7239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKELEW PROGRAMS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BUCKELEW PROGRAMS",
        "enumeration_date": "2023-12-18",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A",
        "authorized_official_last_name": "KUGHN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "415-457-6966",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Buckelew Community Response Team",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.