Individual
SUSAN BUSHEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPS, LPCC, LADC
Contact information
Practice address
1650 CARROLL AVE, SAINT PAUL, MN 55104-5227
(763) 789-4895
(763) 789-4798
Mailing address
11005 OAK GROVE CIRCLE, UNIT B, WOODBURY, MN 55129
(763) 350-7053
(763) 789-4798
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
303614
MN
101YM0800X
Mental Health Counselor
Primary
1197
MN
101YP2500X
Professional Counselor
1197
MN
Other
Enumeration date
01/30/2017
Last updated
03/17/2018
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