Provider Demographics
NPI:1457905291
Name:BUSHEY-REYES, SARA (MA, LPC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:BUSHEY-REYES
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1346
Mailing Address - Street 2:
Mailing Address - City:MARBLE FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:78654-1346
Mailing Address - Country:US
Mailing Address - Phone:830-953-1290
Mailing Address - Fax:
Practice Address - Street 1:105 W JACKSON ST
Practice Address - Street 2:
Practice Address - City:BURNET
Practice Address - State:TX
Practice Address - Zip Code:78611-3122
Practice Address - Country:US
Practice Address - Phone:830-953-1290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78646101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional