1225647464 NPI number — JAMES K BUECHE JR. LCSW

Table of content: JAMES K BUECHE JR. LCSW (NPI 1225647464)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225647464 NPI number — JAMES K BUECHE JR. LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BUECHE
Provider First Name:
JAMES
Provider Middle Name:
K
Provider Name Prefix Text:
Provider Name Suffix Text:
JR.
Provider Credential Text:
LCSW
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225647464
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/23/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 395
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLINTON
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70722-0395
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
225-683-5292
Provider Business Mailing Address Fax Number:
225-683-1310

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
29437 HIGHWAY 63
Provider Second Line Business Practice Location Address:
STE. 14
Provider Business Practice Location Address City Name:
LIVINGSTON
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70754
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-283-1356
Provider Business Practice Location Address Fax Number:
225-683-1310
Provider Enumeration Date:
07/23/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  4286 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4286 . This is a "LCSW LICENSE" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".




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