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MRS. AMY LYNNE BUCKLEY LCSW
NPI 1710008800
Social Worker - Clinical in Port Jefferson, NY

Active since April 03, 2007Opted out of Medicare · through Oct 17, 2027
646 MAIN STREET, PORT JEFFERSON, NY 11777(631) 942-5733 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Amy Lynne Buckley Lcsw NPPES

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

MRS. AMY LYNNE BUCKLEY LCSW (NPI 1710008800) is an individual clinical provider in Port Jefferson, New York, licensed in New York (069255) and active in the NPI registry since April 2007. She has opted out of Medicare through October 17, 2027.

NPPES Registry Identity

NPI1710008800
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMRS. AMY LYNNE BUCKLEYCredential: LCSW
Location Address646 MAIN STREETPort Jefferson, NY 11777
Mailing Address19 View RoadSetauket, NY 11733 · (631) 675-6565
Phone(631) 942-5733
Sole ProprietorYes
Enumeration DateApril 3, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1710008800 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 NY · 069255
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.
646 MAIN STREET, Port Jefferson, NY 11777
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mrs. Amy Lynne Buckley Lcsw has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 17, 2025 through October 17, 2027.

Opt-Out Effective DateOctober 17, 2025
Opt-Out In Effect ThroughOctober 17, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 4

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

MR. DOMINICK LOCIERO LMHC (LICENSE MENTAL
Counselor (Mental Health)
646 MAIN STREET
PORT JEFFERSON, NY 11777
Suffolk County (631) 880-1370
DR. PETER G DEPASQUALE PHD MSW
Social Worker
646 MAIN STREET
PORT JEFFERSON, NY 11777
Suffolk County (631) 689-8180
DR. BARRY S GREENBERG PH.D.
Psychologist (Clinical)
646 MAIN STREET
PORT JEFFERSON, NY 11777
Suffolk County (631) 474-5341
GENEVIEVE HEIDRICH LCSW
Social Worker (Clinical)
646 MAIN STREET
PORT JEFFERSON, NY 11777
Suffolk County (631) 928-4148

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 Amy Buckley's NPI number?

The NPI number for Amy Buckley is 1710008800. It was assigned to this individual provider in the NPPES registry on April 3, 2007.

Where is Amy Buckley located?

Amy Buckley practices at 646 Main Street, Port Jefferson, NY 11777. The listed phone number is (631) 942-5733.

What is Amy Buckley's specialty?

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

Is Amy Buckley enrolled in Medicare?

No. Amy Buckley has opted out of Medicare through October 17, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Amy Buckley 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.