Provider Demographics
NPI:1467050534
Name:LEBEAU-BUSHEE, VERONICA GRACE (LADC1, CADC1)
Entity Type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:GRACE
Last Name:LEBEAU-BUSHEE
Suffix:
Gender:F
Credentials:LADC1, CADC1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 SALEM END RD APT 19B
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-2490
Mailing Address - Country:US
Mailing Address - Phone:508-505-6537
Mailing Address - Fax:
Practice Address - Street 1:34 SALEM END RD APT 19B
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-2490
Practice Address - Country:US
Practice Address - Phone:508-505-6537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA14840101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)