Provider Demographics
NPI:1497286983
Name:BUCHANAN, TERESA DARLENE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:DARLENE
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2492 JANE ADDAMS DR
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-1163
Mailing Address - Country:US
Mailing Address - Phone:210-508-1370
Mailing Address - Fax:
Practice Address - Street 1:433 KITTY HAWK RD
Practice Address - Street 2:SUITE 211
Practice Address - City:UNIVERSAL CITY
Practice Address - State:TX
Practice Address - Zip Code:78148-3357
Practice Address - Country:US
Practice Address - Phone:210-508-1370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-25
Last Update Date:2017-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX525361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical