Provider Demographics
NPI:1700297587
Name:BUHSE, JEANNINE MARIE
Entity Type:Individual
Prefix:
First Name:JEANNINE
Middle Name:MARIE
Last Name:BUHSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2905 GLENAFTON LANE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40217
Mailing Address - Country:US
Mailing Address - Phone:502-974-7966
Mailing Address - Fax:
Practice Address - Street 1:6933 BALLARDSVILLE RD
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:KY
Practice Address - Zip Code:40068-7806
Practice Address - Country:US
Practice Address - Phone:502-640-4464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-1650101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional