Provider Demographics
NPI:1295982171
Name:BUSSIERE, VIVIAN J (LICSW)
Entity type:Individual
Prefix:MS
First Name:VIVIAN
Middle Name:J
Last Name:BUSSIERE
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Gender:F
Credentials:LICSW
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Mailing Address - Street 1:11 LAWRENCE ST
Mailing Address - Street 2:SUITE 322
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01840-1431
Mailing Address - Country:US
Mailing Address - Phone:978-687-1617
Mailing Address - Fax:978-687-1597
Practice Address - Street 1:60 PERSEVERANCE WAY
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-1843
Practice Address - Country:US
Practice Address - Phone:508-862-0600
Practice Address - Fax:508-852-0590
Is Sole Proprietor?:No
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA10292701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical