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General NPI Number Information
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NPI Number | 1598061855
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Entity Type | Individual
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Provider Name | TIA D. BUCHANAN DMIN., LCCC, NCC, LP
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Gender | Female
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Dates
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Enumeration Date | 02/03/2011
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 531 OXFORD ST STE A
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City | SUMTER
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State | SC
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Zip | 29150
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Country | US
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Telephone | 803-565-3878
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Fax | 877-828-9472
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Provider Business Mailing Address
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Address Line | 531 OXFORD ST STE A
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City | SUMTER
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State | SC
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Zip | 29150-3300
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Country | US
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Telephone | 803-565-3878
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Fax | 877-828-9472
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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 | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number | 13741
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6810
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License Number State | SC
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