Provider Demographics
NPI:1467779926
Name:BUSHAY, JILLIAN MAUREEN (LMHC)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:MAUREEN
Last Name:BUSHAY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 VILLAGE INN RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:WESTMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01473-1660
Mailing Address - Country:US
Mailing Address - Phone:978-790-5254
Mailing Address - Fax:
Practice Address - Street 1:23 VILLAGE INN RD
Practice Address - Street 2:SUITE F
Practice Address - City:WESTMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01473-1660
Practice Address - Country:US
Practice Address - Phone:978-790-5254
Practice Address - Fax:978-874-0200
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8281101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health