Individual
KELLY MARIE BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
5106 HAMPTON AVE STE 204, SAINT LOUIS, MO 63109-3115
(636) 208-0114
Mailing address
5106 HAMPTON AVE STE 204, SAINT LOUIS, MO 63109-3115
(636) 208-0114
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2017034803
MO
101YP2500X
Professional Counselor
Primary
2017034803
MO
Other
Enumeration date
06/15/2020
Last updated
08/13/2025
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