Provider Demographics
NPI:1699174987
Name:BUCHANAN, RYAN SCOTT (LCMHC)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:SCOTT
Last Name:BUCHANAN
Suffix:
Gender:M
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 BUNNY RUN RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28716-8913
Mailing Address - Country:US
Mailing Address - Phone:828-734-3491
Mailing Address - Fax:
Practice Address - Street 1:18 CHURCH ST FL 2
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:NC
Practice Address - Zip Code:28716-4457
Practice Address - Country:US
Practice Address - Phone:828-734-3491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-22
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA13187101YP2500X
NC13187101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional