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Organization

PCB PROPERTIES LLC

Active
Other names
Way Maker Recovery
Organization subpart
No

Provider details

NPI number
Authorized official
W PAUL BUCKINGHAM LCSW (MEMBER)
(325) 812-5661
Entity
Organization

Contact information

Practice address
1705 W CHESTNUT ST, LOUISVILLE, KY 40203-1609
(502) 554-2797
Mailing address
1705 W CHESTNUT ST, LOUISVILLE, KY 40203-1609
(502) 554-2797

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7101016660
KY
Enumeration date
02/21/2024
Last updated
02/25/2025
Update your record

If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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