Provider Demographics
NPI:1043401763
Name:BUSET, JOANNA LYNN (LPC)
Entity Type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:LYNN
Last Name:BUSET
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 DAILY ST
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-1530
Mailing Address - Country:US
Mailing Address - Phone:973-464-9608
Mailing Address - Fax:
Practice Address - Street 1:777 PASSAIC AVE
Practice Address - Street 2:SUITE 565
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-1804
Practice Address - Country:US
Practice Address - Phone:973-815-0777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00363900101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional