Provider Demographics
NPI:1780133231
Name:BUCHANAN, AMY (MS, LPC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:NERONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2022 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-1608
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2022 15TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-1608
Practice Address - Country:US
Practice Address - Phone:706-649-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC009162101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional