Provider Demographics
NPI:1396625901
Name:BUCKNER, LASANDRA (PLADC)
Entity type:Individual
Prefix:MRS
First Name:LASANDRA
Middle Name:
Last Name:BUCKNER
Suffix:
Gender:F
Credentials:PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:NE
Mailing Address - Zip Code:69162-1736
Mailing Address - Country:US
Mailing Address - Phone:402-881-0742
Mailing Address - Fax:
Practice Address - Street 1:941 8TH AVE
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:NE
Practice Address - Zip Code:69162-1736
Practice Address - Country:US
Practice Address - Phone:402-881-0742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2356101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty