Individual provider Active NPI

Diane Marie Bush, CADC, LPCC, NCC

  • Mental Health Counselor
  • Louisville, KY
National Provider Identifier
1205425253
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
264319 Issued in KY
Practice address
105 Daventry LN Ste 200
Louisville, KY 40223-3874
Phone
(502) 510-3947
NPI assigned
Jan 14, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 164184 KY
Mental Health Counselor 101YM0800X 264319 KY Primary

Addresses

Primary practice location

105 Daventry LN Ste 200
Louisville, KY 40223-3874

Mailing address

5704 Fruitwood Dr
Louisville, KY 40272-5018
Phone (502) 510-3947

Other identifiers 1

IdentifierTypeStateIssuer
7100818890MedicaidKY

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
164184KYMDAddiction (Substance Use Disorder) Counselor
264319KYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Calm Spirit Counseling LLC Addiction (Substance Use Disorder) CurrentSince May 26, 2024 Accepting new patients

Locations

105 Daventry Ln
Ste 200
Louisville, KY 40223
Phone (502) 510-3947

Organizations & group practices 1

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": "1610582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1205425253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5704 FRUITWOOD DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402725018",
            "telephone_number": "502-510-3947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 DAVENTRY LN STE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402233874",
            "telephone_number": "502-510-3947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "DIANE",
        "middle_name": "MARIE",
        "credential": "CADC, LPCC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-14",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "164184",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "264319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100818890",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; 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.