Provider Demographics
NPI:1881036069
Name:BUSCH, SHEA LYNN (LMFT, LMHC)
Entity Type:Individual
Prefix:
First Name:SHEA
Middle Name:LYNN
Last Name:BUSCH
Suffix:
Gender:F
Credentials:LMFT, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47901-1416
Mailing Address - Country:US
Mailing Address - Phone:765-630-7222
Mailing Address - Fax:
Practice Address - Street 1:904 SOUTH ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47901-1416
Practice Address - Country:US
Practice Address - Phone:765-630-7222
Practice Address - Fax:765-630-7905
Is Sole Proprietor?:No
Enumeration Date:2013-07-29
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
IN39003019A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist