Active NPI
Stephanie Ann Busch, MA, LPC
- Professional Counselor
- Grand Rapids, MI
National Provider Identifier
1609168236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401008939
- Practice address
- 40 Jefferson Ave SE
Grand Rapids, MI 49503-4304 - Phone
- (616) 356-6293
- Fax
- (616) 732-6391
- NPI assigned
- May 16, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401008939 | MI | Primary |
Addresses
Primary practice location
40 Jefferson Ave SE
Grand Rapids, MI 49503-4304
Mailing address
40 Jefferson Ave SE
Grand Rapids, MI 49503-4304
Phone (616) 356-6293
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401008939 | MI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305504000000",
"number": "1609168236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 JEFFERSON AVE SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495034304",
"telephone_number": "616-356-6293",
"fax_number": "616-732-6391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 JEFFERSON AVE SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495034304",
"telephone_number": "616-356-6293",
"fax_number": "616-732-6391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSCH",
"first_name": "STEPHANIE",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "MA, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-16",
"last_updated": "2011-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401008939",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.