BUCKELEW PROGRAMS (NPI# 1619290376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619290376 |
| Entity Type | Organization |
| Organization Name | BUCKELEW PROGRAMS |
| Practice Address |
914 Mission Ave 3rd Floor San Rafael CA 94901-6106 |
| Mailing Address |
144 S E St Santa Rosa CA 95404-4777 |
| Practice Telephone | 4154576964 |
| Mailing Telephone | 7075718476 |
| Mailing Fax Number | 7075715531 |
| Enumeration Date | 2010-03-10 |
| Last Update Date | 2010-03-10 |
| Authorized Official Name | MARK CHRISTOPHER WALTON (FACT/HUD COUNSELOR) |
| Authorized Official Telephone | 7075718476 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861666794 | Buckelew Programs | Community Based Residential Treatment Facility, Mental Illness | 201 Alameda Del Prado Ste 201, Novato, CA 94949-6698 | 2008-04-22 |
| 1619014883 | Buckelew Programs | Clinic/Center | 3000 Bridgeway, Suite 205, Sausalito, CA 94965-1489 | 2007-01-30 |
| 1518012020 | Buckelew Programs | Case Management | 2300 Northpoint Parkway, Santa Rosa, CA 95407 | 2007-01-24 |
| 1972993616 | Buckelew Programs | Community/Behavioral Health | 201 Alameda Del Prado Ste 103, Novato, CA 94949-6698 | 2015-02-03 |
| 1861823262 | Buckelew Programs | Community Based Residential Treatment Facility, Mental Illness | 1109 Sir Francis Drake Blvd, Kentfield, CA 94904-1418 | 2013-12-10 |
| 1659624815 | Buckelew Programs | Community/Behavioral Health | 3270 Kerner Blvd, San Rafael, CA 94901-4840 | 2012-10-24 |
| 1740537992 | Buckelew Programs | Clinic/Center | 201 Alameda Del Prado Ste 201, Novato, CA 94949-6698 | 2012-08-07 |
| 1881987154 | Buckelew Programs | Community/Behavioral Health | 900 5th Ave Ste 150, San Rafael, CA 94901-2928 | 2011-05-19 |
| 1497085146 | Buckelew Programs | Case Management | 914 Mission Ave Fl 3, San Rafael, CA 94901-6106 | 2009-12-31 |
| 1922334622 | Buckelew Programs | Community Based Residential Treatment Facility, Mental Illness | 914 Mission Ave, San Rafael, CA 94901-6106 | 2009-10-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BUCKELEW PROGRAMS | 1401 Los Gamos Dr Ste 240, San Rafael, CA 94903-1835 |
| Street Address |
914 MISSION AVE 3RD FLOOR |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94901-6106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972688927 | Eric Scott Roberts | Counselor | 914 Mission Ave, 3rd Floor, San Rafael, CA 94901-6106 | 2006-10-26 |
| 1780132076 | Ignacio Gallegos Jr. | Counselor | 914 Mission Ave, 3rd Floor, San Rafael, CA 94901-6106 | 2016-09-14 |
| 1568731131 | Sacha C Mcgowan | Counselor | 914 Mission Ave, San Rafael, CA 94901-6106 | 2011-12-27 |
| 1396055729 | Mischelle Williamson | Counselor | 914 Mission Ave, 3 Rd Floor, San Rafael, CA 94901 | 2010-10-19 |
| 1417276403 | John Daniel Heibel | Counselor | 914 Mission Ave, 3rd Floor, San Rafael, CA 94901-6106 | 2010-05-31 |
| 1073845590 | Susan Jane Thomas-sampson | Counselor | 914 Mission Ave, 3rd Floor, San Rafael, CA 94901-6106 | 2010-02-09 |
| 1891026670 | Patricia Barret | Counselor | 914 Mission Ave, 3rd Floor, San Rafael, CA 94901-6106 | 2010-01-19 |
| 1467783415 | Kalia Lynn Chan | Counselor | 914 Mission Ave, San Rafael, CA 94901-6106 | 2010-01-14 |
| 1669702221 | Kristina Aileen Danz | Counselor | 914 Mission Ave, 3rd Floor, San Rafael, CA 94901-6106 | 2010-01-05 |
| 1437489242 | Vinita Jo Anthony | Counselor | 914 Mission Ave, San Rafael, CA 94901-6106 | 2009-12-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780207134 | Marianne Haissman Stefancic | Marriage & Family Therapist | 409 Forbes Ave., San Rafael, CA 94901 | 2020-05-20 |
| 1093292765 | Marin Community Clinic | Clinic/Center | 411 4th Strteet, Suite A, San Rafael, CA 94901 | 2018-07-25 |
| 1275052516 | Laura Ellen Silverstein | Marriage & Family Therapist | 600 Fifth Avenue, San Rafael, CA 94901 | 2017-09-19 |
| 1689101107 | Marin Family Recovery | Clinic/Center | 1209 Third St. Ste 4, San Rafael, CA 94901 | 2017-05-15 |
| 1376070011 | Tencia Beavers-sanchez | Counselor | 710 C Street Suite#8, Marin Outpatient&recoveryservices, Sanrafael, CA 94901 | 2017-05-12 |
| 1326584905 | Jamie Waterman | Emergency Medical Technician, Basic | 675 Sir Francis Drake Blvd, Kentfield, CA 94901 | 2017-01-06 |
| 1295270676 | Stephen Marks | Counselor | 900 Fifth Avenue, Suite 150, ; San Rafael, CA 94901 | 2016-12-21 |
| 1497299812 | Vesna Sturman | Psychologist | 712 D St Ste L, San Rafael, CA 94901 | 2016-12-05 |
| 1063955771 | Carol Dutton Hollenberg | Behavior Technician | 503 D St., San Rafael, CA 94901 | 2016-11-29 |
| 1083069447 | Bay Area Community Resources | Community/Behavioral Health | 103 Shoreline Parkway, San Rafael, CA 94901 | 2016-05-04 |
| Find all providers in zip 94901 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396396826 | Family Matters of Marin | Community/Behavioral Health | 1346 4th St Ste 202, San Rafael, CA 94901-2860 | 2019-09-25 |
| 1083069447 | Bay Area Community Resources | Community/Behavioral Health | 103 Shoreline Parkway, San Rafael, CA 94901 | 2016-05-04 |
| 1144687302 | Ritter Center | Community/Behavioral Health | 190 Mill St, Dining Room, San Rafael, CA 94901-4021 | 2016-01-19 |
| 1619362662 | Center Point, Inc. | Community/Behavioral Health | 199 Mill St., San Rafael, CA 94901 | 2015-04-06 |
| 1902204597 | Dba Nancy Freitas Lambert Psyd | Community/Behavioral Health | 1330 Lincoln Ave Ste 102b, San Rafael, CA 94901-2141 | 2014-12-12 |
| 1669878765 | Seneca Family of Agencies | Community/Behavioral Health | 25 W Castlewood Dr, San Rafael, CA 94901-2538 | 2014-11-17 |
| 1396141198 | Seneca Family of Agencies | Community/Behavioral Health | 177 N San Pedro Rd, San Rafael, CA 94903-4200 | 2014-11-06 |
| 1376957373 | Shana Gaviglio Kenney | Community/Behavioral Health | 1665 Grand Ave, San Rafael, CA 94901-2211 | 2014-06-17 |
| 1104256411 | John Hamel & Associates | Community/Behavioral Health | 28 Upper Oak Dr, San Rafael, CA 94903-1732 | 2013-11-22 |
| 1093073876 | Bay Area Community Resources, Inc | Community/Behavioral Health | 3240 Kerner Blvd, San Rafael, CA 94901-4840 | 2012-04-30 |
| Find all providers in SAN RAFAEL | ||||
| City | SAN RAFAEL |
| Zip Code | 94901 |
Please comment or provide details below to improve the information on BUCKELEW PROGRAMS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.