Provider Demographics
NPI:1518733906
Name:BUECHNER, KATHARINE ALYSSA (LMSW)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:ALYSSA
Last Name:BUECHNER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:976 BOULDERCREST DR SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-2261
Mailing Address - Country:US
Mailing Address - Phone:678-592-2370
Mailing Address - Fax:
Practice Address - Street 1:3700 MARTIN LUTHER KING JR DR SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-3674
Practice Address - Country:US
Practice Address - Phone:470-825-1341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW0114171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical