Provider Demographics
NPI:1114632940
Name:BUCHANAN, CARRIE (MSW)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 GRAHAM RD STE B
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-1344
Mailing Address - Country:US
Mailing Address - Phone:330-510-4900
Mailing Address - Fax:330-510-5900
Practice Address - Street 1:421 GRAHAM RD STE B
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-1344
Practice Address - Country:US
Practice Address - Phone:330-510-4900
Practice Address - Fax:330-510-5900
Is Sole Proprietor?:No
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.23086861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHS.2308686OtherOHIO COUNSELOR SOCIAL WORKER AND MARRIAGE AND FAMILY THERAPIST BOARD