Provider Demographics
NPI:1992278105
Name:BUCHANAN, ARTHUR (CDCA)
Entity type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:
Last Name:BUCHANAN
Suffix:
Gender:M
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 BROADWAY ST STE 1313
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43609-2809
Mailing Address - Country:US
Mailing Address - Phone:419-509-3242
Mailing Address - Fax:
Practice Address - Street 1:1301 BROADWAY ST STE 1313
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43609-2809
Practice Address - Country:US
Practice Address - Phone:419-509-3242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.167594101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)