Diane Carolyn Buchanan, PHD, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY7596 Issued in FL

Practice address

146 Lansing Island Dr
Indian Harbour Beach, FL 32937-5353

Phone

(321) 779-6848

NPI assigned

Nov 20, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1174037659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 LANSING ISLAND DR",
            "city": "INDIAN HARBOUR BEACH",
            "state": "FL",
            "postal_code": "329375353",
            "telephone_number": "321-779-6848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 LANSING ISLAND DR",
            "city": "INDIAN HARBOUR BEACH",
            "state": "FL",
            "postal_code": "329375353",
            "telephone_number": "321-779-6848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4251 Stack Blvd Apt 2174",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329018526",
            "country_code": "US",
            "telephone_number": "847-219-0989",
            "fax_number": "847-219-0989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCHANAN",
        "first_name": "DIANE",
        "middle_name": "CAROLYN",
        "credential": "PHD, PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY7596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Indian Harbour Beach, FL
• Providers in Indian Harbour Beach, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.