Individual provider · Type 1 NPI

Kelly Marie Buckley, LPC

Professional Counselor · St. Louis, MO

NPI number 1720603830 Active

Practice location

5106 Hampton Ave Ste 204
St. Louis, MO 63109-3115

Call (636) 208-0114 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800X2017034803 (MO)
Professional Counselor Primary 101YP2500X2017034803 (MO)

Professional Counselor: Definition to come...

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About NPI 1720603830

Kelly Marie Buckley, LPC's National Provider Identifier is 1720603830, issued on Jun 15, 2020. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in St. Louis, MO. The record was last updated on Aug 13, 2025.