Provider Demographics
NPI:1780746966
Name:BUCHANAN, JENNIFER CECILE (LPC, LAC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:CECILE
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:LPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 FILLMORE ST
Mailing Address - Street 2:APT. 238
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-1557
Mailing Address - Country:US
Mailing Address - Phone:303-396-9962
Mailing Address - Fax:
Practice Address - Street 1:1650 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-1407
Practice Address - Country:US
Practice Address - Phone:303-396-9962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4839101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional