Provider Demographics
NPI:1215258884
Name:BUCHANAN, KAREN ELIZABETH (MS)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:ELIZABETH
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4904 WATERS EDGE DR
Mailing Address - Street 2:SUITE 151
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-2484
Mailing Address - Country:US
Mailing Address - Phone:919-389-9827
Mailing Address - Fax:
Practice Address - Street 1:4904 WATERS EDGE DR
Practice Address - Street 2:SUITE 151
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-2484
Practice Address - Country:US
Practice Address - Phone:919-389-9827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0381103T00000X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor