Nicole Marie Busch I

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

2101 Fox Dr Ste 102
Champaign, IL 61820-8195

Phone

(217) 213-3405

Fax

(217) 403-9557

NPI assigned

Jun 21, 2010

Last updated

Feb 25, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1437470879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 FOX DR STE 102",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618208195",
            "telephone_number": "217-213-3405",
            "fax_number": "217-403-9557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 FOX DR STE 102",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618208195",
            "telephone_number": "217-213-3405",
            "fax_number": "217-403-9557"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "202 W Park Ave",
            "address_purpose": "LOCATION",
            "city": "Champaign",
            "state": "IL",
            "postal_code": "618203929",
            "country_code": "US",
            "telephone_number": "217-378-2213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSCH",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_suffix": "I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-21",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erik Duane Burgwald, OD
• Andrea Burie, M.S. CCC-SLP
• Hannah Rose Burkiett
• Brandi Elizabeth Burque, PH.D.
• Rachel Burris, RBT
• Caitlin Bush
• Jessica Marie Bushman, L.M.P.
• Jesse Buss, MSW, LSW, QMHP
• Tia Butler, LCSW
• Michelle L. Buxton, LCSW

• Clinical Social Worker in Champaign, IL
• Providers in Champaign, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; 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.