Individual provider Active NPI

Jessica Rene Bush

  • Clinical Social Worker
  • Memphis, TN
National Provider Identifier
1194153528
Registry record updated Feb 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
2298 Young Ave Unit 362
Memphis, TN 38104-5755
Phone
(901) 303-8486
Fax
(901) 425-0199
NPI assigned
Oct 22, 2013
Last updated
Feb 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

2298 Young Ave Unit 362
Memphis, TN 38104-5755

Mailing address

2298 Young Ave Unit 362
Memphis, TN 38104-5755
Phone (901) 303-8486

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
7637TNMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1382400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771804800000",
    "number": "1194153528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2298 YOUNG AVE UNIT 362",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381045755",
            "telephone_number": "901-303-8486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2298 YOUNG AVE UNIT 362",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381045755",
            "telephone_number": "901-303-8486",
            "fax_number": "901-425-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "JESSICA",
        "middle_name": "RENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-22",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.