BUCKELEW PROGRAMS (NPI# 1740537992) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740537992 |
| Entity Type | Organization |
| Organization Name | BUCKELEW PROGRAMS |
| Other Organization Name | BUCKELEW COUNSELING SERVICES |
| Practice Address |
201 Alameda Del Prado Ste 201 Novato CA 94949-6698 |
| Mailing Address |
201 Alameda Del Prado Ste 103 Novato CA 94949-6698 |
| Practice Telephone | 4154915700 |
| Mailing Telephone | 4154576964 |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2020-08-20 |
| Authorized Official Name | MR. JOHN CHRISTOPHER KUGHN (CEO) |
| Authorized Official Telephone | 4154576966 |
| Authorized Official Credential | LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Buckelew Counseling Services | Other Name - Individual/Organization |
| Counseling Services | Other Name - Individual/Organization |
| 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 |
| 1881987154 | Buckelew Programs | Community/Behavioral Health | 900 5th Ave Ste 150, San Rafael, CA 94901-2928 | 2011-05-19 |
| 1619290376 | Buckelew Programs | Community/Behavioral Health | 914 Mission Ave, 3rd Floor, San Rafael, CA 94901-6106 | 2010-03-10 |
| 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 |
201 ALAMEDA DEL PRADO STE 201 |
| City | NOVATO |
| State | CA |
| Zip Code | 94949-6698 |
| 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 |
| 1558969873 | Adeel Ahmad | Counselor | 201 Alameda Del Prado Ste 201, Novato, CA 94949-6698 | 2020-10-09 |
| 1861050205 | Khlood Salah | Counselor | 201 Alameda Del Prado Ste 201, Novato, CA 94949-6698 | 2019-05-31 |
| 1649731704 | Rebecca Newton | Counselor | 201 Alameda Del Prado Ste 201, Novato, CA 94949-6698 | 2019-03-29 |
| 1194067611 | Arthur Ray Davidson | Counselor | 201 Alameda Del Prado Ste 201, Novato, CA 94949-6698 | 2013-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295365427 | Rebecca Pia Ashkenazy | Counselor | 201 Alameda Del Prado Suite 201, Novato, CA 94949 | 2020-01-15 |
| 1063073583 | Minding Your Body | Clinic/Center | 250 Bel Marin Keys Boulevard, Suite D1, Nevato, CA 94949 | 2019-06-25 |
| 1750743555 | Shivani Vasishta | Physician Assistant | 5800 Nave Dr, Novato, CA 94949 | 2016-03-22 |
| 1780065516 | Sikander Isshak | Pharmacist | 437 Via Del Plano, Novato, CA 94949 | 2015-06-17 |
| 1619224763 | Kerby Ann Gleeson | Social Worker | 1385 North Hamilton Parkway, Novato, CA 94949 | 2012-08-08 |
| 1295094241 | Stacy Anne Rosenblatt | Social Worker | 1385 North Hamilton Prkway, Novato, CA 94949 | 2012-05-11 |
| 1487913505 | Lifecare Solutions Inc | Durable Medical Equipment & Medical Supplies | 394 Bel Marin Keys Blvd, Suite 4, Novato, CA 94949 | 2012-05-09 |
| 1609181213 | Vincent Gregory Pons | Internal Medicine | 448 Ignacio Blvd, No. 403, Novato, CA 94949 | 2010-08-09 |
| 1811217946 | Prima Medical Foundation | Clinic/Center | 4 Hamilton Landing, Suite 100, Novato, CA 94949 | 2010-06-11 |
| 1770776957 | Lisa Marutani | Registered Nurse | 21 Tamal Vista, 100, Corte Madera, CA 94949 | 2007-08-22 |
| Find all providers in zip 94949 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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|---|---|---|---|---|
| 1811034051 | Family Service Agency of Marin | Clinic/Center | 1907 Novato Blvd, Novato, CA 94947-2912 | 2007-01-30 |
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| 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.