Nicole Rae Buesse, MA, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2021042212 Issued in MO

Practice address

17014 New College Ave Ste 206
Wildwood, MO 63040-1108

Phone

(636) 393-8771

NPI assigned

Nov 21, 2022

Last updated

Sep 6, 2023By the provider in NPPES

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1668988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1831808534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17014 NEW COLLEGE AVE STE 206",
            "city": "WILDWOOD",
            "state": "MO",
            "postal_code": "630401108",
            "telephone_number": "636-393-8771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17014 NEW COLLEGE AVE STE 206",
            "city": "WILDWOOD",
            "state": "MO",
            "postal_code": "630401108",
            "telephone_number": "636-393-8771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUESSE",
        "first_name": "NICOLE",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-21",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2021042212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Wildwood, MO
• Providers in Wildwood, MO by specialty
• Mental Health Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.