Individual provider Active NPI

Jacqueline Bush, LMFT, BC-TMH

  • Marriage & Family Therapist
  • Charlotte, NC
National Provider Identifier
1073012647
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2118 Issued in NC
Practice address
227 W 4TH St Ste 321
Charlotte, NC 28202-1545
Phone
(704) 879-1179
Fax
(704) 490-4274
NPI assigned
Feb 8, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X 2118 NC Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X MFT002250 GA
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X 0717002128 VA
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X LCM1108 MD
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X TPMF251 FL
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X MFT1586 LA
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X LMFT200001420 DC
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X 206218 TX
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X 7054 SC
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X

Addresses

Primary practice location

227 W 4TH St Ste 321
Charlotte, NC 28202-1545

Mailing address

PO Box 82406
Baton Rouge, LA 70884-2406
Phone (704) 879-1179

Other practice location 1

10202 Perkins Rowe Ste E160
Baton Rouge, LA 70810-2067
Phone (704) 879-1179

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LMFT200001420DCMDMarriage & Family Therapist
TPMF251FLMDMarriage & Family Therapist
MFT002250GAMDMarriage & Family Therapist
MFT1586LAMDMarriage & Family Therapist
LCM1108MDMDMarriage & Family Therapist
206218TXMDMarriage & Family Therapist
0717002128VAMDMarriage & Family Therapist
2118NCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Transformative Vision PLLC Current Accepting new patients
Transformative Vision Marriage & Family Therapist Current Accepting new patients

Locations

10202 Perkins Rowe
Ste 160
Baton Rouge, LA 70810

227 W 4th St
Charlotte, NC 28202
Phone (704) 879-1179

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1518048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1073012647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82406",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708842406",
            "telephone_number": "704-879-1179",
            "fax_number": "704-490-4274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 W 4TH ST STE 321",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282021545",
            "telephone_number": "704-879-1179",
            "fax_number": "704-490-4274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10202 Perkins Rowe Ste E160",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708102067",
            "country_code": "US",
            "telephone_number": "704-879-1179",
            "fax_number": "704-490-4274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSH",
        "first_name": "JACQUELINE",
        "credential": "LMFT, BC-TMH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-08",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "2118",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT002250",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717002128",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "MD",
            "license": "LCM1108",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "TPMF251",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "LA",
            "license": "MFT1586",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "DC",
            "license": "LMFT200001420",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "206218",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "SC",
            "license": "7054",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.