Sonja R Buckles-Smith, LCMHCS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

S9891 Issued in NC

Practice address

2210 Coronation Blvd
Suite D
Charlotte, NC 28227

Phone

(704) 773-3956

Fax

(704) 919-0474

NPI assigned

Jan 20, 2007

Last updated

Sep 16, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Mrs. Sonja Rochelle Buckles Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Amanda K. Crowder, LCSW, PLLC

  dba Calming Waters Counseling Services

  • Clinical Social Worker
  • Charlotte, NC
  • NPI 1447647532
  NPD (past)

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

{
    "created_epoch": "1169251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1720131782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2722 IMPATIEN DRIVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28215",
            "telephone_number": "704-773-3956",
            "fax_number": "704-919-0474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 CORONATION BLVD",
            "address_2": "SUITE D",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28227",
            "telephone_number": "704-773-3956",
            "fax_number": "704-919-0474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLES-SMITH",
        "first_name": "SONJA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "LCMHCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-20",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "S9891",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "9891",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "9891",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005959500",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6115145",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SONJA",
            "last_name": "BUCKLES",
            "middle_name": "ROCHELLE",
            "prefix": "MRS.",
            "credential": "LPC, LPCS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joshua Buck, D.C.
• Rebecca Buck
• Brandie Rose Buckingham, PA-C
• Michael John Buckingham, D.C.
• Ashley Buckius, MPH OTD OTR/L
• Cheryl Buckley, RDN, CDN , MBA , MS
• Elizabeth Atkison Buckley, CD-L
• Kevin Stuart Buckley, MD
• Lashena Sharay Buckley
• Kylie Buckman, L.AC, DIPL. OM

• Mental Health Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.