Active NPI
Marcy Ann Bush, PHD
- Clinical Psychologist
- Pittsford, NY
National Provider Identifier
1174650352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 009307
- Practice address
- One Lookwood Drive
Suite 100
Pittsford, NY 14534 - Phone
- (585) 383-0030
- Fax
- (585) 383-1858
- NPI assigned
- Feb 27, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009307 | NY | MD | Clinical Psychologist |
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 009307 | NY | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
One Lookwood Drive
Suite 100
Pittsford, NY 14534
Mailing address
110 Glenhill Drive
Rochester, NY 14618
Phone (585) 473-0481
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7165336 | Other | NY | AETNA |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174650352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 GLENHILL DRIVE",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "14618",
"telephone_number": "585-473-0481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ONE LOOKWOOD DRIVE",
"address_2": "SUITE 100",
"city": "PITTSFORD",
"state": "NY",
"postal_code": "14534",
"telephone_number": "585-383-0030",
"fax_number": "585-383-1858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSH",
"first_name": "MARCY",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "009307",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7165336",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pittsford, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.