Melinda Bush, BS CADC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Niles, MI

NPI 1356779243 · NPPES record last updated Oct 31, 2013

Key facts

NPI
1356779243
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
2-01222 (MI)
Practice address
1225 S 11TH St
Niles, MI 49120-3408
Phone
(269) 684-7741
Fax
(269) 684-3671
NPI assigned
Oct 31, 2013
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
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
2-01222MIMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 2-01222 MI Yes

Addresses

Primary practice location

1225 S 11TH St
Niles, MI 49120-3408

Mailing address

1225 S 11TH St
Niles, MI 49120-3408
Phone (269) 684-7741

Other providers in Niles, MI

All providers in Niles, MI · Addiction (Substance Use Disorder) Counselor in Michigan

Sources for this page

Verify at the official NPI Registry.