Provider Demographics
NPI:1063203321
Name:BUCHANAN, MAGAN A
Entity type:Individual
Prefix:
First Name:MAGAN
Middle Name:A
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 SPARKMAN ST SW
Mailing Address - Street 2:
Mailing Address - City:HARTSELLE
Mailing Address - State:AL
Mailing Address - Zip Code:35640-3120
Mailing Address - Country:US
Mailing Address - Phone:256-502-9582
Mailing Address - Fax:205-449-5066
Practice Address - Street 1:530 SPARKMAN ST SW
Practice Address - Street 2:
Practice Address - City:HARTSELLE
Practice Address - State:AL
Practice Address - Zip Code:35640-3120
Practice Address - Country:US
Practice Address - Phone:256-502-9582
Practice Address - Fax:205-449-5066
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6348G104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker