| Doctor Name: | JONATHAN JAY BUSCH |
| NPI Number: | 1417208380 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC |
| License Number: | ORDAINED 248986 2 |
| Business Practice Address: | 37451 252nd St White Lake, SD - 573835620 |
| Business Phone Number: | 6056821484 |
| Business Fax Number: | |
| Mailing Address: | 37451 252nd St, WHITE LAKE |
| State: | SD |
| Postal Code: | 573835620 |
| Phone Number: | 6056821484 |
| Fax Number: | |
| NPI Enumeration Date: | 10/01/2012 |
| NPI Last Update Date: | 10/01/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP1600X |
| License Number: | ORDAINED 248986 2 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | SD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Pastoral |
| Taxonomy Definition: | |