Provider Demographics
NPI:1467041707
Name:BUSECK, LYNZEE (MS, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:LYNZEE
Middle Name:
Last Name:BUSECK
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4644 BANNOCK LN
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-5800
Mailing Address - Country:US
Mailing Address - Phone:307-214-5006
Mailing Address - Fax:
Practice Address - Street 1:4644 BANNOCK LN
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-5800
Practice Address - Country:US
Practice Address - Phone:307-214-5006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-12
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC-1685101YP2500X
COLPC.0017118101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WYLPC-1685OtherWYOMING MENTAL HEALTH PROFESSIONS LICENSING BOARD
COLPC.0017118OtherCOLORADO DEPARTMENT OF REGULATORY AGENCIES