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JILL MARIE BUCKINGHAM DTR, LICSW
NPI 1235295148
Social Worker - Clinical in Shoreview, MN

Active since December 28, 2006PECOS Enrolled
3490 LEXINGTON AVE N STE 205, SHOREVIEW, MN 55126(651) 486-3808(651) 486-3858 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jill Marie Buckingham Dtr, Licsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JILL MARIE BUCKINGHAM DTR, LICSW (NPI 1235295148) is an individual clinical provider in Shoreview, Minnesota, licensed in Minnesota (12099) and active in the NPI registry since December 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1235295148
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameJILL MARIE BUCKINGHAMCredential: DTR, LICSW
Location Address3490 LEXINGTON AVE N STE 205Shoreview, MN 55126-8044
Mailing Address3490 Lexington Ave N Ste 205Shoreview, MN 55126-8044 · (651) 486-3808 · Fax (651) 486-3858
Phone(651) 486-3808
Fax(651) 486-3858
Sole ProprietorNo
Enumeration DateDecember 28, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1235295148 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in MN · 12099
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
3490 LEXINGTON AVE N STE 205, Shoreview, MN 55126
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jill Marie Buckingham Dtr, Licsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55126 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $56.00 – $168.28
Typical copayment $0.00 (range $14.00 – $42.07)
Most-billed visit code NA
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JACLYN ROSE SUCHY
Counselor (Professional)
3490 LEXINGTON AVE N STE 205
SHOREVIEW, MN 55126
Ramsey County (651) 486-3808
VICKI LYNN SCHROEDER LICSW
Social Worker
3490 LEXINGTON AVE N STE 205
SHOREVIEW, MN 55126
Ramsey County (651) 486-3808
VANESSA ANN SHUCK MSW, LGSW
Social Worker
3490 LEXINGTON AVE N STE 205
SHOREVIEW, MN 55126
Ramsey County (651) 486-3808
TRISHA LYNN LORRAINE SARGENT LICSW
Social Worker (Clinical)
3490 LEXINGTON AVE N STE 205
SHOREVIEW, MN 55126
Ramsey County (651) 379-3414
MISS CARLA KAHALE ANTON LMFT
Marriage & Family Therapist
3490 LEXINGTON AVE N STE 205
SHOREVIEW, MN 55126
Ramsey County (651) 486-3808
MS. LUCILLE AMIS-ROSARIO MSW, LICSW
Social Worker (Clinical)
3490 LEXINGTON AVE N STE 205
SHOREVIEW, MN 55126
Ramsey County (651) 486-3808
MR. STEVEN RICHARD LUTES LICSW
Social Worker (Clinical)
3490 LEXINGTON AVE N STE 205
SHOREVIEW, MN 55126
Ramsey County (651) 486-3808
SAMANTHA ROSE LUECK MSW, LGSW
Social Worker (Clinical)
3490 LEXINGTON AVE N STE 205
SHOREVIEW, MN 55126
Ramsey County (651) 379-3429

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jill Buckingham's NPI number?

The NPI number for Jill Buckingham is 1235295148. It was assigned to this individual provider in the NPPES registry on December 28, 2006.

Where is Jill Buckingham located?

Jill Buckingham practices at 3490 Lexington Ave N Ste 205, Shoreview, MN 55126. The listed phone number is (651) 486-3808.

What is Jill Buckingham's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Jill Buckingham enrolled in Medicare?

Yes. Jill Buckingham is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jill Buckingham was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.