Provider Demographics
NPI:1710785944
Name:BUSTOS, CATHERINE MARIE (COUNSELOR)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MARIE
Last Name:BUSTOS
Suffix:
Gender:
Credentials:COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 MIDDLE CRK
Mailing Address - Street 2:
Mailing Address - City:BUDA
Mailing Address - State:TX
Mailing Address - Zip Code:78610-2766
Mailing Address - Country:US
Mailing Address - Phone:512-574-0802
Mailing Address - Fax:
Practice Address - Street 1:1216 DUNCAN RD
Practice Address - Street 2:
Practice Address - City:COPPERAS COVE
Practice Address - State:TX
Practice Address - Zip Code:76522-7409
Practice Address - Country:US
Practice Address - Phone:254-577-4880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92015101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health