Individual
MARCY BETH BUCKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
3915 GOLDEN VALLEY ROAD, COURAGE CENTER, GOLDEN VALLEY, MN 55422-4298
(763) 520-0463
(763) 520-0355
Mailing address
3915 GOLDEN VALLEY ROAD, COURAGE CENTER, GOLDEN VALLEY, MN 55422-4298
(763) 520-0463
(763) 520-0355
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11250
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6236582
UBH
—
01
—
63D31BU
BCBS MINNESOTA
MN
01
—
963371008127
PREFERRED ONE
—
01
—
HP38889
HEALTHPARTNERS
—
Enumeration date
06/20/2006
Last updated
07/08/2007
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