Provider Demographics
NPI:1639846264
Name:BUCHANAN, VANESSA (LCSW, LISW, LICDC)
Entity type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:LCSW, LISW, LICDC
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:
Other - Last Name:BURLINGAME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5715 PRINCESS ANNE RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3222
Mailing Address - Country:US
Mailing Address - Phone:757-962-0748
Mailing Address - Fax:
Practice Address - Street 1:5715 PRINCESS ANNE RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3222
Practice Address - Country:US
Practice Address - Phone:757-962-0748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2001393-TRNE104100000X
VA0903003982104100000X
OHS.2310146104100000X
OHI.24057331041C0700X
VA0710103957101YA0400X
OHLICDC.162672101YA0400X
VA09060125101041C0700X
VA09040172171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)