MEDICARE: FRANKIE BUCHANAN GREEN LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC.0017470	CO

General Provider Information

NPI Number	:	1043871882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANKIE BUCHANAN GREEN LPC

Provider Business Mailing Address
First Line	:	PO BOX 121
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80522-0121
Country	:	US
Telephone Number	:	970-297-7599
Fax Number	:

Provider Business Practice Location Address
First Line	:	418 S HOWES ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-2802
Country	:	US
Telephone Number	:	970-297-7599
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2019
Last Update Date	:	01/14/2022

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