Individual
BRITTANY BUCKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
3860 W OGDEN AVE, CHICAGO, IL 60623-2460
(872) 588-3000
Mailing address
3504 W EVERGREEN AVE, CHICAGO, IL 60651-2220
(920) 207-7476
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
180009497
IL
101YP2500X
Professional Counselor
Primary
180009497
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180009497
STATE LICENSE
IL
Enumeration date
06/06/2016
Last updated
09/20/2021
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