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General NPI Number Information
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NPI Number | 1922119015
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Entity Type | Individual
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Provider Name | TERRY A. BUSTER M.S. LCPC, LMFT,LPC
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1509 N WHITLEY DR SUITE 11
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City | FRUITLAND
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State | ID
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Zip | 83619-2259
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Country | US
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Telephone | 208-452-2162
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Fax | 208-452-1232
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Provider Business Mailing Address
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Address Line | 508 CORNWALL WAY
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City | FRUITLAND
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State | ID
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Zip | 83619-2544
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LCPC-3188
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C-1425
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT-2631
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License Number State | ID
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