Provider Demographics
NPI:1740535335
Name:BUCHANAN, BETH E (LCSW)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:E
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1040 SIERRA DR STE 400
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-7241
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:317-355-6096
Practice Address - Street 1:5230 E STOP 11 RD STE 350
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-6402
Practice Address - Country:US
Practice Address - Phone:317-783-8383
Practice Address - Fax:317-782-6929
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN34004658A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN34004658AOtherLICENSE