=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649053497
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ADRIENNE LYNN BUCHANAN LCSW, LCADC , CCS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/16/2023
-----------------------------------------------------
Last Update Date | 06/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4 PRINCESS RD STE 208
-----------------------------------------------------
City | LAWRENCEVILLE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08648-2322
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-566-6277
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 136 CORNELL BLVD
-----------------------------------------------------
City | SOMERVILLE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08876-1833
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-566-6277
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 44SC06413500
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------