Provider Demographics
NPI:1417491689
Name:BUSSE & REID LLC
Entity Type:Organization
Organization Name:BUSSE & REID LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSSE
Authorized Official - Suffix:
Authorized Official - Credentials:MED, MA, LPCC
Authorized Official - Phone:612-219-8633
Mailing Address - Street 1:916 ARABIAN DR
Mailing Address - Street 2:
Mailing Address - City:JORDAN
Mailing Address - State:MN
Mailing Address - Zip Code:55352-3406
Mailing Address - Country:US
Mailing Address - Phone:612-219-8633
Mailing Address - Fax:
Practice Address - Street 1:6001 EGAN DR STE 170
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-4919
Practice Address - Country:US
Practice Address - Phone:612-219-8633
Practice Address - Fax:612-930-0111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-07
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN01313101YP2500X
MN01314101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty