Healthcare Provider Details

I. General information

NPI: 1497666317
Provider Name (Legal Business Name): THOMAS BUCHENOT LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 GAINES SCHOOL RD STE A
ATHENS GA
30605-3103
US

IV. Provider business mailing address

405 GAINES SCHOOL RD STE A
ATHENS GA
30605-3103
US

V. Phone/Fax

Practice location:
  • Phone: 706-363-3932
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberMSW013160
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: