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Individual

MELISSA A BUSTAMANTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
11900 COLLEGE BLVD STE 310, OVERLAND PARK, KS 66210-4048
(913) 318-4679
Mailing address
11900 COLLEGE BLVD STE 310, OVERLAND PARK, KS 66210-4048
(913) 318-4679

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC 2511
KS
101YM0800X
Mental Health Counselor
LPC 2539
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0268768
OH
05
201080470B
KS
Enumeration date
06/27/2012
Last updated
12/13/2023
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