Individual provider Active NPI

Mandy Buckland, M.A., P.C

  • Professional Counselor
  • Toledo, OH
National Provider Identifier
1700209046
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1100418 Issued in OH
Practice address
6629 W Central Ave
Toledo, OH 43617-1098
Phone
(419) 517-1070
Fax
(419) 517-1399
NPI assigned
Jan 22, 2014
Last updated
Jan 22, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1100418 OH Primary

Addresses

Primary practice location

6629 W Central Ave
Toledo, OH 43617-1098

Mailing address

PO Box 8970
Toledo, OH 43623-0970
Phone (419) 475-4449

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1100418OHMDProfessional Counselor

Interoperability endpoints

  • Direct secure messaging: mandy.buckland.1@14940.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1390348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390348800000",
    "number": "1700209046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8970",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436230970",
            "telephone_number": "419-475-4449",
            "fax_number": "419-475-1399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6629 W CENTRAL AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436171098",
            "telephone_number": "419-517-1070",
            "fax_number": "419-517-1399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLAND",
        "first_name": "MANDY",
        "name_prefix": "Ms.",
        "credential": "M.A., P.C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-22",
        "last_updated": "2014-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "1100418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; 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.