Provider Demographics
NPI:1346695210
Name:BUCHANAN, JEANA (LMFT)
Entity Type:Individual
Prefix:
First Name:JEANA
Middle Name:
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4008 DRY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3834
Mailing Address - Country:US
Mailing Address - Phone:512-818-3044
Mailing Address - Fax:
Practice Address - Street 1:4810B SPICEWOOD SPRINGS RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8740
Practice Address - Country:US
Practice Address - Phone:512-481-2616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-28
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201662106H00000X
CA37881106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist