Nour Majid Bussard, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC016176 Issued in PA

Practice address

11106 State Highway 18 Ste 102
Conneaut Lake, PA 16316-3620

Phone

(000) 000-0000

NPI assigned

Apr 28, 2021

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Karima Mental Health Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Conneaut Lake, PA
  • NPI 1013789874
  NPD

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1144802190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11106 STATE HIGHWAY 18 STE 102",
            "city": "CONNEAUT LAKE",
            "state": "PA",
            "postal_code": "163163620",
            "telephone_number": "814-631-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11106 STATE HIGHWAY 18 STE 102",
            "city": "CONNEAUT LAKE",
            "state": "PA",
            "postal_code": "163163620",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSSARD",
        "first_name": "NOUR",
        "middle_name": "MAJID",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-28",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC016176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devin Nicole Bielata, MA, NCC
• Chrissy M Bosley, LCSW QCSW
• Casey James Chapman, DC
• Kimberly Marie Conley, LCSW
• Conneaut Lake Area Ambulance Service
• Conneaut Lake Chiropractic, PC
• Conneaut Valley Health Center Inc.

• Professional Counselor in Conneaut Lake, PA
• Providers in Conneaut Lake, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.