MRS. KELLY ANN BUCK (NPI# 1578825345) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578825345 |
| Entity Type | Individual |
| Full Name | MRS. KELLY ANN BUCK |
| Credential | M.S., ED |
| Practice Address |
1045 James St Syracuse NY 13203-2730 |
| Practice Telephone | 3154271004 |
| Practice Fax Number | 3154254855 |
| Mailing Telephone | 3154251004 |
| Mailing Fax Number | 3154224855 |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2012-06-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Q00000X | Developmental Therapist | $$$$$$$$$ | NY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871019190 | Kelly Kathleen Buck | Social Worker | 547 S 20th St W Ste 5, Billings, MT 59102-6445 | 2017-08-17 |
| 1346776192 | Kelly K. Buck | Massage Therapist | 221 Race St Apt 5, Bainbridge, PA 17502-9013 | 2017-05-11 |
| 1689128175 | Kelly Anne Buck | Dentist | 6760 Abrams Rd, Dallas, TX 75231-7177 | 2016-08-12 |
| 1427162353 | Kelly Dawn Buck | Registered Nurse | 1481 W 10th St, Indianapolis, IN 46202-2803 | 2006-08-18 |
| Street Address |
1045 JAMES ST |
| City | SYRACUSE |
| State | NY |
| Zip Code | 13203-2730 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013912153 | Alida Anne Dejong | Registered Nurse | 1045 James St, Syracuse, NY 13203-2730 | 2005-06-16 |
| 1326648395 | Liberty Resources Psychology, Physical, Occupational and Speech Therap | Early Intervention Provider Agency | 1045 James St, Syracuse, NY 13203-2730 | 2020-10-29 |
| 1083211619 | Tracy L. Eckstrand | Developmental Therapist | 1045 James St, Syracuse, NY 13203-2730 | 2020-10-06 |
| 1306458070 | Amy Marie Ruetsch | Developmental Therapist | 1045 James St, Syracuse, NY 13203-2730 | 2020-08-23 |
| 1891306742 | Nichole Dawn Slate | Social Worker | 1045 James St, Syracuse, NY 13203-2730 | 2020-08-13 |
| 1245849280 | Louis Shirley | Peer Specialist | 1045 James St, Syracuse, NY 13203-2730 | 2020-07-27 |
| 1083232367 | Melissa Louise Potter | Developmental Therapist | 1045 James St, Syracuse, NY 13203-2730 | 2020-07-13 |
| 1881221885 | Kirsten Melville | Developmental Therapist | 1045 James St, Syracuse, NY 13203-2730 | 2020-03-27 |
| 1699302380 | Jennifer Breau | Counselor | 1045 James St, Syracuse, NY 13203-2730 | 2020-03-24 |
| 1679109771 | Lora M Denero | Developmental Therapist | 1045 James St, Syracuse, NY 13203-2730 | 2020-03-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659998193 | Allison Elizabeth Mills | Social Worker | 1045 James St., Syracuse, NY 13203 | 2020-07-01 |
| 1467004333 | Humanitarian Organization for Multicultural Experiences, Inc. | Psychologist | 831 James Street, Syracuse, NY 13203 | 2019-07-11 |
| 1215405287 | Wellness Therapy Services Lcsw, Pllc | Counselor | Wellness Therapy Services Lcsw, Pllc, 404 Oak St. #200, Syracuse, NY 13203 | 2018-11-08 |
| 1962904912 | Michael Musante | Developmental Therapist | 1045 James Streret, Syracuse, NY 13203 | 2018-03-06 |
| 1811410236 | Lindsey Deborah Sanborn | Nurse Practitioner | 301 Prospect Avenue St. Josephs's Hospital Health Cente, Syracuse, NY 13203 | 2017-07-18 |
| 1497205975 | Phuong Pham | Counselor | 329 North Salina Street, Syracuse, NY 13203 | 2016-10-10 |
| 1942754015 | Shelly Lynn Peters | Nurse Practitioner | 329 N. Salina Street, Helio Health, Syracuse, NY 13203 | 2016-08-06 |
| 1932574217 | Kaleigh Marie Andino | Audiologist | 1001 James Street, Syracuse, NY 13203 | 2015-12-11 |
| 1376889493 | Brenda S Hartman-souder | Social Worker | 526 Oak St., Syracuse, NY 13203 | 2012-12-18 |
| 1386914711 | Steven W Dimarzo | Counselor | 404 Oak St Ste 320, Syracuse, NY 13203 | 2012-01-02 |
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| Taxonomy Code | 222Q00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Developmental Therapist |
| A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development. |
| Notes: Source: The Illinois Developmental Therapists Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962904912 | Michael Musante | Developmental Therapist | 1045 James Streret, Syracuse, NY 13203 | 2018-03-06 |
| 1083211619 | Tracy L. Eckstrand | Developmental Therapist | 1045 James St, Syracuse, NY 13203-2730 | 2020-10-06 |
| 1306458070 | Amy Marie Ruetsch | Developmental Therapist | 1045 James St, Syracuse, NY 13203-2730 | 2020-08-23 |
| 1083232367 | Melissa Louise Potter | Developmental Therapist | 1045 James St, Syracuse, NY 13203-2730 | 2020-07-13 |
| 1881221885 | Kirsten Melville | Developmental Therapist | 1045 James St, Syracuse, NY 13203-2730 | 2020-03-27 |
| 1679109771 | Lora M Denero | Developmental Therapist | 1045 James St, Syracuse, NY 13203-2730 | 2020-03-20 |
| 1437784881 | Robin Lee Pierce | Developmental Therapist | 1045 James St, Syracuse, NY 13203-2730 | 2020-03-05 |
| 1326685827 | Katherine Elizabeth Verdi | Developmental Therapist | 1045 James St, Syracuse, NY 13203-2730 | 2019-12-03 |
| 1790335826 | Mara T Kinney | Developmental Therapist | 1045 James St, Syracuse, NY 13203-2730 | 2019-09-20 |
| 1669029252 | Devin Emillina Case | Developmental Therapist | 1045 James St, Syracuse, NY 13203-2730 | 2019-08-20 |
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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.