Provider Demographics
NPI:1922046770
Name:BUSS, DANIEL J (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:J
Last Name:BUSS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 FOREST ST
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54403-5524
Mailing Address - Country:US
Mailing Address - Phone:715-842-0944
Mailing Address - Fax:715-845-6477
Practice Address - Street 1:2417 POST RD
Practice Address - Street 2:BLDG A, SUITE H
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-6124
Practice Address - Country:US
Practice Address - Phone:800-236-3792
Practice Address - Fax:715-845-6477
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 101YP2500X, 106H00000X
WI22051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1922046770Medicaid
WI1922046770Medicaid