Provider Demographics
NPI:1457145047
Name:BUCHANAN, JENNIFER LEANN (TCADC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEANN
Last Name:BUCHANAN
Suffix:
Gender:
Credentials:TCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 MIDLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-7791
Mailing Address - Country:US
Mailing Address - Phone:502-647-0154
Mailing Address - Fax:
Practice Address - Street 1:213 MIDLAND BLVD
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-7791
Practice Address - Country:US
Practice Address - Phone:502-647-0154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY297826101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)