Provider Demographics
NPI:1770842122
Name:BUCHANAN, LAKIA NICOLE (LCSWA)
Entity Type:Individual
Prefix:
First Name:LAKIA
Middle Name:NICOLE
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 WALSENBURG DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27712-1369
Mailing Address - Country:US
Mailing Address - Phone:919-864-8165
Mailing Address - Fax:
Practice Address - Street 1:412 WALSENBURG DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27712-1369
Practice Address - Country:US
Practice Address - Phone:347-513-4332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-04
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25458101YA0400X
NCP0129441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)