Active NPI
Contessa Bush
- Mental Health Counselor
- Beachwood, OH
National Provider Identifier
1336679901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- S1700279
- Practice address
- 24200 Chagrin Blvd
Beachwood, OH 44122-5550 - Phone
- (216) 831-6466
- Fax
- (216) 766-6084
- NPI assigned
- Jun 15, 2017
- 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 | S1700279 | OH | Primary |
Addresses
Primary practice location
24200 Chagrin Blvd
Beachwood, OH 44122-5550
Mailing address
13620 Maplerow Ave
Garfield Heights, OH 44105-6802
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9166922 | Other | OH | NEOHS PTAN |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S1700279 | OH | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychological & Behavioral Consultants, LLC | Mental Health | Past | Accepting new patients |
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.
-
dba LifeStance Health
- Psychiatry Physician
- Beachwood, OH
- NPI 1811915713
Mental Health
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497484800000",
"number": "1336679901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13620 MAPLEROW AVE",
"city": "GARFIELD HEIGHTS",
"state": "OH",
"postal_code": "441056802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24200 CHAGRIN BLVD",
"city": "BEACHWOOD",
"state": "OH",
"postal_code": "441225550",
"telephone_number": "216-831-6466",
"fax_number": "216-766-6084"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSH",
"first_name": "CONTESSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-15",
"last_updated": "2017-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "S1700279",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEOHS PTAN",
"identifier": "9166922",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beachwood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.