Christopher Jordan Buckley
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Morro Bay, CA
NPI 1891517751 · NPPES record last updated Oct 30, 2024
Key facts
- NPI
- 1891517751
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- R1537101123 (CA)
- Practice address
- 2460 Main St
Morro Bay, CA 93442-1552 - Phone
- (805) 772-2122
- NPI assigned
- Oct 30, 2024
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R1537101123 | CA | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | R1537101123 | CA | Yes |
Addresses
Primary practice location
2460 Main St
Morro Bay, CA 93442-1552
Mailing address
2460 Main St
Morro Bay, CA 93442-1552
Phone (805) 772-2122
Other providers in Morro Bay, CA
- Lisa Marie Boyd
- Ashley Elizabeth Bramon
- Bravemind Wellness Group
- James W Breedlove
- Josselynn Annette Brewer
- Hoa Ngoc Thanh Bui
- Amir Burstein
- Katelyn Cagle
- Thomas Joseph Cantwell III
- Central Coast Mobility
All providers in Morro Bay, CA · Addiction (Substance Use Disorder) Counselor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.