MEDICARE: DR. JANET CAROLE BUSSEY PHD, LCSW-C, LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LC3000763	DC
2	1041C0700X	Clinical Social Worker	12805	MD

General Provider Information

NPI Number	:	1225276355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANET CAROLE BUSSEY PHD, LCSW-C, LICSW

Provider Business Mailing Address
First Line	:	1636 CRITTENDEN ST NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20017-3125
Country	:	US
Telephone Number	:	202-832-8846
Fax Number	:

Provider Business Practice Location Address
First Line	:	1636 CRITTENDEN ST NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20017-3125
Country	:	US
Telephone Number	:	202-832-8846
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2009
Last Update Date	:	01/27/2009

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