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Individual

STANLEY BUCKLEY

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
LMSW, RAODAC

Contact information

Practice address
1929 W 21ST ST N, WICHITA, KS 67203-2106
(316) 660-7700
(316) 838-2115
Mailing address
635 N MAIN ST, WICHITA, KS 67203-3602
(316) 660-7600
(316) 383-7925

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0053
KS
104100000X
Social Worker
2796
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
389906
BLUE CROSS BLUE SHIELD
KS
01
4137
PREFERRED HEALTH SYSTEMS
KS
Enumeration date
06/12/2006
Last updated
09/11/2025
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