Michelle Bush, LAC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Shawnee, KS

NPI 1336545003 · NPPES record last updated Nov 7, 2014

Key facts

NPI
1336545003
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
267 (KS)
Practice address
6221 Richards Dr
Shawnee, KS 66216-1724
Phone
(913) 248-1943
Fax
(913) 248-1994
NPI assigned
Nov 7, 2014
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

State licenses

LicenseStateTypeSpecialty
267KSMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 267 KS Yes

Addresses

Primary practice location

6221 Richards Dr
Shawnee, KS 66216-1724

Mailing address

PO Box 711
Newton, KS 67114-0711
Phone (316) 283-6743

Other identifiers

IdentifierTypeStateIssuer
100106710 IMedicaidKS

Other providers in Shawnee, KS

All providers in Shawnee, KS · Addiction (Substance Use Disorder) Counselor in Kansas

Sources for this page

Verify at the official NPI Registry.