Provider Demographics
NPI:1922853688
Name:BUSSIERE, CAILEY ROSE (LMHC)
Entity Type:Individual
Prefix:
First Name:CAILEY
Middle Name:ROSE
Last Name:BUSSIERE
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 1:5 WEST ST # 2
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-7135
Mailing Address - Country:US
Mailing Address - Phone:978-857-2321
Mailing Address - Fax:
Practice Address - Street 1:23 MELLEN ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-2757
Practice Address - Country:US
Practice Address - Phone:857-331-6331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMHC10001592101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health