| Buchanan Synergy Inc. | |
|
2404 Ellis St, Suite 4, Venus, Tx 76084 Venus TX 76084-3327 | |
| (682) 339-9149 | |
| Not Available |
| Full Name | Buchanan Synergy Inc. |
|---|---|
| Speciality | Counselor |
| Location | 2404 Ellis St, Suite 4, Venus, Tx 76084, Venus, Texas |
| Authorized Official Name and Position | Alicia Garner (OWNER) |
| Authorized Official Contact | 3095123040 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Buchanan Synergy Inc. 1781 Highway 287 N # 1042 Mansfield TX 76063-4807 Ph: (682) 339-9149 | Buchanan Synergy Inc. 2404 Ellis St, Suite 4, Venus, Tx 76084 Venus TX 76084-3327 Ph: (682) 339-9149 |
| NPI Number | 1649908260 |
|---|---|
| Provider Enumeration Date | 08/11/2022 |
| Last Update Date | 08/12/2022 |
| Certification Date | 08/12/2022 |
| Medicare PECOS PAC ID | 7315315009 |
|---|---|
| Medicare Enrollment ID | O20221130003147 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649908260 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Sedrick Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811443039 PECOS PAC ID: 9032406772 Enrollment ID: I20161202000694 |
| Provider Name | Jazmin Veronik Graham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407243694 PECOS PAC ID: 4880968668 Enrollment ID: I20170918000962 |
| Provider Name | Laquindra M Carroll |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194316083 PECOS PAC ID: 8729495734 Enrollment ID: I20210318000322 |
| Provider Name | Kimberly Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629784020 PECOS PAC ID: 2163895632 Enrollment ID: I20230302002907 |
| Provider Name | Alicia Beatrice Burley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427830199 PECOS PAC ID: 3072961481 Enrollment ID: I20231127000144 |
| Provider Name | Evelyn Salazar Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497441588 PECOS PAC ID: 1254789191 Enrollment ID: I20231202000361 |