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General NPI Number Information
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NPI Number | 1679289896
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Entity Type | Individual
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Provider Name | AMY VISCOMI BUCHANAN LCMHCA
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Gender | Female
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Dates
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Enumeration Date | 01/31/2023
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Last Update Date | 01/31/2023
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Provider Practice Location Address
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Address Line | 7480 WATERSIDE LOOP RD
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City | DENVER
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State | NC
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Zip | 28037-7929
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Country | US
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Telephone | 704-483-3783
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Fax |
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Provider Business Mailing Address
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Address Line | 1620 CORDIA CIR
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City | NEWTON
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State | NC
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Zip | 28658-7809
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Country | US
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Telephone | 828-446-3469
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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 | NC-A18505
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License Number State | NC
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