Individual provider Active NPI

Catherine Buckner

  • Clinical Social Worker
  • Lansing, MI
National Provider Identifier
1770922833
Registry record updated Jun 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801094812 Issued in MI
Practice address
812 E Jolly Rd
Suite 111
Lansing, MI 48910-6818
Phone
(517) 346-8312
NPI assigned
Jun 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801094812 MI Primary

Addresses

Primary practice location

812 E Jolly Rd
Suite 111
Lansing, MI 48910-6818

Mailing address

812 E Jolly Rd
Suite 210
Lansing, MI 48910-6818
Phone (517) 346-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240618001909 NC Practitioner - Clinical Social Worker 5496298531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Psychological Associates PAGroup PAC ID 9335187442, 12 clinicians

Practice addresses (Care Compare)

10001 Old Concord Rd
Charlotte, NC 28213-3646
Phone (704) 547-1483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801094812MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
University Psychological Associates, P.a. CurrentSince Jun 5, 2024 Accepting new patients
Community Mental Health Authority of Clinton Eaton Ingham Counties PastSince Mar 1, 2011 Accepting new patients

Locations

726 East Blvd
Charlotte, NC 28203
Phone (704) 376-8494

10001 Old Concord Rd
Charlotte, NC 28213
Phone (704) 547-1483

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1371772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371772800000",
    "number": "1770922833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 E JOLLY RD",
            "address_2": "SUITE 210",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489106818",
            "telephone_number": "517-346-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 E JOLLY RD",
            "address_2": "SUITE 111",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489106818",
            "telephone_number": "517-346-8312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKNER",
        "first_name": "CATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-21",
        "last_updated": "2013-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801094812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.