Active NPI
Ilene M Bustos, MA, ATR-BC, LPC
- Mental Health Counselor
- East Stroudsburg, PA
National Provider Identifier
1285095042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- PC008451
- Practice address
- 529 Seven Bridge Rd
Suite 203
East Stroudsburg, PA 18301-7937 - Phone
- (570) 431-3005
- NPI assigned
- Mar 8, 2016
- Last updated
- Jul 2, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | PC008451 | PA | Primary |
Addresses
Primary practice location
529 Seven Bridge Rd
Suite 203
East Stroudsburg, PA 18301-7937
Mailing address
529 Seven Bridge Rd
Suite 203
East Stroudsburg, PA 18301-7937
Phone (570) 431-3005
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 14, 2024 through May 14, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PC008451 | PA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719878400000",
"number": "1285095042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "529 SEVEN BRIDGE RD",
"address_2": "SUITE 203",
"city": "EAST STROUDSBURG",
"state": "PA",
"postal_code": "183017937",
"telephone_number": "570-431-3005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "529 SEVEN BRIDGE RD",
"address_2": "SUITE 203",
"city": "EAST STROUDSBURG",
"state": "PA",
"postal_code": "183017937",
"telephone_number": "570-431-3005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSTOS",
"first_name": "ILENE",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "MA, ATR-BC, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-03-08",
"last_updated": "2024-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "PA",
"license": "PC008451",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Stroudsburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.