Provider Demographics
NPI:1427211531
Name:BUSCHAUER, MIKKI LEVI (MS LMFT)
Entity Type:Individual
Prefix:
First Name:MIKKI
Middle Name:LEVI
Last Name:BUSCHAUER
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:MRS
Other - First Name:MICHAL
Other - Middle Name:
Other - Last Name:LEVI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:1664 ARD EEVIN AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-1224
Mailing Address - Country:US
Mailing Address - Phone:818-625-4275
Mailing Address - Fax:
Practice Address - Street 1:150 S LOS ROBLES AVE STE 860
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-4628
Practice Address - Country:US
Practice Address - Phone:818-625-4275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53014 INTERN106H00000X
CA48609106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist