Provider Demographics
NPI:1760471981
Name:BUCHANAN, LESLIE MCKEE (LICSW, MLADC)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:MCKEE
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:LICSW, MLADC
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:
Other - Last Name:BUCHANAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW, MLADC
Mailing Address - Street 1:SALEM PSYCHOLOGICAL ASSOCIATES
Mailing Address - Street 2:87 STILES RD, SUITE 106
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079
Mailing Address - Country:US
Mailing Address - Phone:603-893-7707
Mailing Address - Fax:603-893-7331
Practice Address - Street 1:87 STILES RD
Practice Address - Street 2:SALEM PSYCHOLOGICAL ASSOCIATION - SUITE 106
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2899
Practice Address - Country:US
Practice Address - Phone:603-893-7707
Practice Address - Fax:603-893-7331
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH10371041C0700X
NH0890101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH1039256OtherCIGNA
NH14Y001354NH08OtherBLUE CROSS/BLUE SHIELD
NH14Y001354NH08OtherBLUE CROSS/BLUE SHIELD