Provider Demographics
NPI:1992829121
Name:SCHERZ BUSCH, NIRA (MS)
Entity Type:Individual
Prefix:MS
First Name:NIRA
Middle Name:
Last Name:SCHERZ BUSCH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:NIRA
Other - Middle Name:
Other - Last Name:MELZER BUSCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:437 S YELLOWSTONE DRIVE
Mailing Address - Street 2:SUITE # 218
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719
Mailing Address - Country:US
Mailing Address - Phone:608-288-1882
Mailing Address - Fax:608-288-1892
Practice Address - Street 1:437 S YELLOWSTONE DRIVE
Practice Address - Street 2:SUITE # 218
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719
Practice Address - Country:US
Practice Address - Phone:608-288-1882
Practice Address - Fax:608-288-1892
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI144058101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39190500Medicaid