# BUSHMAN PSYCHOLOGICAL SERVICES LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861580607
- **Authorized official:** KIMBERLY BUSHMAN PHD. LP (PRESIDENT)
- **Authorized official phone:** (952) 898-5020

## Contact information

- **Practice address:** 14551 JUDICIAL RD STE 100, BURNSVILLE, MN 55306-4991
- **Practice address phone:** (952) 898-5020
- **Practice address fax:** (952) 898-5858
- **Mailing address:** 14551 JUDICIAL RD STE 100, BURNSVILLE, MN 55306-4991
- **Mailing address phone:** (952) 898-5020
- **Mailing address fax:** (952) 898-5858

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | LP3946 | MN | Yes |

## Other

- **Enumeration date:** 10/10/2006
- **Last updated:** 04/05/2018