Provider Demographics
NPI:1902240526
Name:BUCHANAN, DANETTE (LCPC)
Entity Type:Individual
Prefix:
First Name:DANETTE
Middle Name:
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2227 OLD EMMORTON RD
Mailing Address - Street 2:SUITE 119
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-6187
Mailing Address - Country:US
Mailing Address - Phone:410-569-9497
Mailing Address - Fax:410-569-0094
Practice Address - Street 1:6004 WATERLOO RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2631
Practice Address - Country:US
Practice Address - Phone:410-569-9497
Practice Address - Fax:410-569-0094
Is Sole Proprietor?:No
Enumeration Date:2013-04-25
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4898101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional