Provider Demographics
NPI:1235996562
Name:BUCHTENKIRCH, ERIC ALAN (LMHC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:ALAN
Last Name:BUCHTENKIRCH
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14701 CUMBERLAND RD STE 170
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-8715
Mailing Address - Country:US
Mailing Address - Phone:317-813-9087
Mailing Address - Fax:
Practice Address - Street 1:14701 CUMBERLAND RD STE 170
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-8715
Practice Address - Country:US
Practice Address - Phone:317-813-9087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39004858A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health