Provider Demographics
NPI:1740750108
Name:BUCHANAN, YUSEF
Entity Type:Individual
Prefix:
First Name:YUSEF
Middle Name:
Last Name:BUCHANAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 CHINQUAPIN ROUND RD STE 2L
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-4006
Mailing Address - Country:US
Mailing Address - Phone:410-990-1811
Mailing Address - Fax:
Practice Address - Street 1:420 CHINQUAPIN ROUND RD STE 2L
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-4006
Practice Address - Country:US
Practice Address - Phone:410-990-1811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-28
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC9136101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health