Provider Demographics
NPI:1033700240
Name:BUCHHORN, JAMIE PK (MED, LPC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:PK
Last Name:BUCHHORN
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1859 BURR OAK LN
Mailing Address - Street 2:
Mailing Address - City:ADKINS
Mailing Address - State:TX
Mailing Address - Zip Code:78101-2606
Mailing Address - Country:US
Mailing Address - Phone:866-748-2305
Mailing Address - Fax:866-748-2534
Practice Address - Street 1:1859 BURR OAK LN
Practice Address - Street 2:
Practice Address - City:ADKINS
Practice Address - State:TX
Practice Address - Zip Code:78101-2606
Practice Address - Country:US
Practice Address - Phone:866-748-2305
Practice Address - Fax:866-748-2534
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-30
Last Update Date:2021-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60123101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional