MEDICARE: JENNIFER CECILE BUCHANAN LPC, LAC

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	4839	CO

General Provider Information

NPI Number	:	1780746966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER CECILE BUCHANAN LPC, LAC

Provider Business Mailing Address
First Line	:	1600 FILLMORE ST
Second Line	:	APT. 238
City	:	DENVER
State	:	CO
Zip	:	80206-1557
Country	:	US
Telephone Number	:	303-396-9962
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 WASHINGTON ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-1407
Country	:	US
Telephone Number	:	303-396-9962
Fax Number	:

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

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	09/19/2012

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