Anna Michelle Buckner, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2279 Issued in MS

Practice address

1635 Lelia Dr Ste 100
Jackson, MS 39216-4876

Phone

(601) 362-7020

NPI assigned

May 30, 2018

Last updated

Aug 3, 2022By 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 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Michelle Buckner Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jackson, MS
  • NPI 1821889130
  NPD Authorized official
• Live Oak Psychological Associtaes

  • Clinical Psychologist
  • Jackson, MS
  • NPI 1750577805
  NPD (past)

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

{
    "created_epoch": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1851883565",
    "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",
            "telephone_number": "662-418-7785"
        },
        {
            "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": {
        "last_name": "BUCKNER",
        "first_name": "ANNA",
        "middle_name": "MICHELLE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-30",
        "last_updated": "2022-08-03",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "2279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://michellebucknercounseling.clientsecure.me/",
            "affiliation": "N",
            "endpointDescription": "Simple Practice EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "N/A",
            "address_1": "1635 Lelia Dr Ste 100",
            "city": "Jackson",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392164876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kelly Buckholdt, PH.D.
• Mary Hannah Bucklew, NP
• Christen H Buckley, NP-C
• Evan Anthony Buckley, DO
• Buckner Prosthetic and Orthotic Laboratories Inc.
• Deyanna Buckner
• Dominique Jaquetta Nicole Buckner
• Ernest W Bueche II, ATC
• Maria Ximena Bueno, M.D.
• Lauren Whitton Buffington, NP-C

• Professional Counselor in Jackson, MS
• Providers in Jackson, MS by specialty
• Professional Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.