Provider Demographics
NPI:1487054326
Name:BUCHANAN, RAVEN (MSW)
Entity type:Individual
Prefix:
First Name:RAVEN
Middle Name:
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 MACDADE BLVD
Mailing Address - Street 2:
Mailing Address - City:COLLINGDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19023-3826
Mailing Address - Country:US
Mailing Address - Phone:610-938-9379
Mailing Address - Fax:
Practice Address - Street 1:800 MACDADE BLVD
Practice Address - Street 2:
Practice Address - City:COLLINGDALE
Practice Address - State:PA
Practice Address - Zip Code:19023-3826
Practice Address - Country:US
Practice Address - Phone:610-938-9379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-28
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool