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Stantavius Buckner , BS

Social Worker β€’ Westland, MI

Deactivated NPI 1265963904 Deactivated in NPPES Male Practitioner
Practice location in NPPES

8623 N Wayne Rd
Westland, MI 481851137

Phone: 7344250636

Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

This NPI Is Deactivated in NPPES

NPPES lists this NPI as deactivated as of September 17, 2026; the reason is not published. The records below are historical. They do not show whether Stantavius Buckner currently practices or holds a license; check the state medical board for current license status.

NPI Enumeration Date March 24, 2017
NPI Deactivation Date September 17, 2026
NPI Active Period 2017 – 2026

Practice Location & Contact Primary Location

Practice Address

8623 N Wayne Rd

Westland, MI 481851137

Telephone 7344250636
Fax 7344254771
Organization at the Same NPPES Address or Phone
Hegira Health, Inc. Facility NPI 1710049374

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2017

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Compared with the same specialty in Westland and Michigan

Comparisons are not shown because NPPES lists this NPI as deactivated.

Sources: CMS Doctors and Clinicians, CMS release of October 2, 2026, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Social Worker Primary Specialty

NUCC Taxonomy Code: 104100000X

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Michigan Department of Licensing and Regulatory Affairs.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

2 listed
Soha Alammoury

Nurse Practitioner - Psychiatric/Mental Health

NPI 1750730834
Alfred Spitzer , MS LLP

Counselor - Addiction (Substance Use Disorder)

NPI 1396766945

MSLLP

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
⚠️
NPI Profile Deactivated September 17, 2026

NPPES lists this NPI as deactivated as of September 17, 2026; the reason is not published.

βœ…
NPI Profile Active March 24, 2017

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) March 24, 2017

Registered at 8623 N WAYNE RD, WESTLAND, MI 481851137 (Tel: 7344250636)

πŸ“
Business Mailing Address (Initial Record) March 24, 2017

Registered at 8623 N WAYNE RD, WESTLAND, MI 481851137 (Tel: 7344250636)

πŸ‘€
Provider Name / Credentials (Initial Record) March 24, 2017

Recorded as STANTAVIUS BUCKNER, BS

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 24, 2017

Social Worker

🟒
Initial NPI Registration & Enumeration March 24, 2017

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1265963904
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 24, 2017
Last Update: August 02, 2026
Deactivation Date: September 17, 2026
Sole Proprietor: No

Mailing Address

8623 N Wayne Rd

Westland, MI 481851137

Phone: 7344250636

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.