Provider Demographics
NPI:1710395330
Name:BUCHANAN, ANGELA ELAINE
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:ELAINE
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2272
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28793-2272
Mailing Address - Country:US
Mailing Address - Phone:828-692-7300
Mailing Address - Fax:
Practice Address - Street 1:2 S BROWN CT
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-0744
Practice Address - Country:US
Practice Address - Phone:828-505-6012
Practice Address - Fax:828-692-7710
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-28
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0134841041C0700X
NC3502-A101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical