Provider Demographics
NPI:1730499153
Name:BUSSEY, JEANETTE LYNN (MSC, MFT)
Entity Type:Individual
Prefix:MS
First Name:JEANETTE
Middle Name:LYNN
Last Name:BUSSEY
Suffix:
Gender:F
Credentials:MSC, MFT
Other - Prefix:MS
Other - First Name:JEANETTE
Other - Middle Name:LYNN
Other - Last Name:BUSSEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:990 TERESA PL
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-0651
Mailing Address - Country:US
Mailing Address - Phone:775-232-7659
Mailing Address - Fax:866-232-8311
Practice Address - Street 1:850 MILL ST STE 100
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1463
Practice Address - Country:US
Practice Address - Phone:775-624-8861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-19
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01202106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist