Jan Bussell

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Marshall, TX

NPI 1386130201 · NPPES record last updated Jul 3, 2018

Key facts

NPI
1386130201
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
13341 (TX)
Practice address
1204 Harper Dr
Marshall, TX 75672-5712
Phone
(512) 497-6541
NPI assigned
Jul 3, 2018
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
McEt-Waskom Limited Liability Company Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 13341 TX Yes

Addresses

Primary practice location

1204 Harper Dr
Marshall, TX 75672-5712

Mailing address

670 Spur 156
Waskom, TX 75692-9129
Phone (903) 687-2586

Other providers in Marshall, TX

All providers in Marshall, TX · Addiction (Substance Use Disorder) Counselor in Texas

Sources for this page

Verify at the official NPI Registry.