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General NPI Number Information
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NPI Number | 1104546423
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Entity Type | Individual
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Provider Name | CORRINE FAYE BUCHANAN PH.D., LMHC, LMFT
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Gender | Female
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Dates
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Enumeration Date | 08/29/2022
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 2601 NW 23RD BLVD APT 134
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City | GAINESVILLE
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State | FL
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Zip | 32605-5952
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Country | US
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Telephone | 386-212-0874
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Fax |
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Provider Business Mailing Address
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Address Line | 7901 4TH ST N STE 8198
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4305
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Country | US
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Telephone | 386-212-0874
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C9869
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT5112
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH19538
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License Number State | FL
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