Provider Demographics
NPI:1568037109
Name:BUCHANAN, DEBORAH KAY (LCPC-C)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:KAY
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:LCPC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WILDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-2234
Mailing Address - Country:US
Mailing Address - Phone:865-405-1345
Mailing Address - Fax:
Practice Address - Street 1:2 WILDWOOD DR
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-2234
Practice Address - Country:US
Practice Address - Phone:865-405-1345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL6214101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional