Active NPI
Michelle Buckner Counseling, PLLC
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Jackson, MS
National Provider Identifier
1821889130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Legal business name
- MICHELLE BUCKNER COUNSELING, PLLC
- Practice address
- 1635 Lelia Dr Ste 100
Jackson, MS 39216-4876 - Phone
- (601) 362-7020
- NPI assigned
- May 15, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Anna Michelle Buckner, LPC
- Title
- President
- Phone
- (601) 362-7020
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Primary |
Addresses
Primary practice location
1635 Lelia Dr Ste 100
Jackson, MS 39216-4876
Mailing address
PO Box 711
Bolton, MS 39041-0711
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250529001567 | MS | Part B Supplier - Clinic/Group Practice | 6800315110 | Practice locations: Jackson, MS |
National Provider Directory
National Provider DirectoryLocations
1635 Lelia Dr
Ste 100
Jackson, MS 39216
Phone (601) 362-7020
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Professional Counselor
- Jackson, MS
- NPI 1851883565
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747267200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1747267200000",
"number": "1821889130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 711",
"city": "BOLTON",
"state": "MS",
"postal_code": "390410711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1635 LELIA DR STE 100",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164876",
"telephone_number": "601-362-7020"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MICHELLE BUCKNER COUNSELING, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-05-15",
"last_updated": "2025-05-15",
"certification_date": "2025-05-15",
"status": "A",
"authorized_official_last_name": "BUCKNER",
"authorized_official_first_name": "ANNA",
"authorized_official_middle_name": "MICHELLE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "601-362-7020",
"authorized_official_credential": "LPC"
},
"taxonomies": [
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.