Provider Demographics
NPI:1356226047
Name:BUCKSON, MARSHA MICHELLE (LCSW)
Entity type:Individual
Prefix:
First Name:MARSHA
Middle Name:MICHELLE
Last Name:BUCKSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10121 ENDFIELD WAY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95127-3709
Mailing Address - Country:US
Mailing Address - Phone:912-503-0752
Mailing Address - Fax:
Practice Address - Street 1:10121 ENDFIELD WAY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95127-3709
Practice Address - Country:US
Practice Address - Phone:912-503-0752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1324541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical