Provider Demographics
NPI:1518394790
Name:BUCKLER, JULIE HACK (LMSW)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:HACK
Last Name:BUCKLER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 VAN DE BOGART RD.
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:NY
Mailing Address - Zip Code:12498
Mailing Address - Country:US
Mailing Address - Phone:845-679-2160
Mailing Address - Fax:
Practice Address - Street 1:325 COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-1902
Practice Address - Country:US
Practice Address - Phone:518-828-9446
Practice Address - Fax:518-828-9450
Is Sole Proprietor?:No
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY72 073358104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker