Mavis A Bush
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Canton, NY
NPI 1043400658 · NPPES record last updated Jul 30, 2007
Key facts
- NPI
- 1043400658
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- Practice address
- 80 State Highway 310
Suite 1
Canton, NY 13617-1493 - Phone
- (315) 386-2189
- Fax
- (315) 386-2435
- NPI assigned
- Jul 30, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lawrence County | Addiction (Substance Use Disorder) | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Yes |
Addresses
Primary practice location
80 State Highway 310
Suite 1
Canton, NY 13617-1493
Mailing address
80 State Highway 310
Suite 1
Canton, NY 13617-1493
Phone (315) 386-2189
Other names
- Mavis A Hart
Other providers in Canton, NY
- Sarah N Buck-Morrill
- Angela Burke
- William B. Burns
- Melinda D Burwell
- Melchiore Louis Buscemi
- Virginia Ann Buwell
- Samantha Campbell
- Canton Central School District
- Canton Enriched Housing Program, Inc
- Canton Family Physicians, P.C.
All providers in Canton, NY · Addiction (Substance Use Disorder) Counselor in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.