Bush Counseling Service LCSW PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BUSH COUNSELING SERVICE LCSW PLLC

Practice address

4673 State Highway 58
Gouverneur, NY 13642-3202

Phone

(386) 888-6464

Fax

(386) 888-6465

NPI assigned

Oct 4, 2019

Organization subpart

No

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

Authorized official

Name

Selena Bush, LCSW

Title

Owner

Phone

(386) 888-6464

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Miranda Dekker

  • Clinical Social Worker
  • Forked River, NJ
  • NPI 1285197301
  NPD

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

{
    "created_epoch": "1570147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608508800000",
    "number": "1467093054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4673 STATE HIGHWAY 58",
            "city": "GOUVERNEUR",
            "state": "NY",
            "postal_code": "136423202",
            "telephone_number": "386-888-6464",
            "fax_number": "386-888-6465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4673 STATE HIGHWAY 58",
            "city": "GOUVERNEUR",
            "state": "NY",
            "postal_code": "136423202",
            "telephone_number": "386-888-6464",
            "fax_number": "386-888-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUSH COUNSELING SERVICE LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-04",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A",
        "authorized_official_last_name": "BUSH",
        "authorized_official_first_name": "SELENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-888-6464",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05620695",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.bushcounselingservice.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4673 State Highway 58",
            "city": "Gouverneur",
            "state": "NY",
            "country_code": "US",
            "postal_code": "136423202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.bushcounselingservice.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4673 State Highway 58",
            "city": "Gouverneur",
            "state": "NY",
            "country_code": "US",
            "postal_code": "136423202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jill A. Brabant, ARNP
• Susan Kane Bradley, PHARMD
• Laurie Faye Brown, NP
• Gary A Bryant
• Martha Hamilton Burt, PT
• Selena Bush, LCSW
• Gerald L Calabrese, MD
• Shandria Card
• Nadhia Celestin, M.D.
• Debby Ann Colton, RN

• Clinical Social Worker in Gouverneur, NY
• Providers in Gouverneur, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2020; 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.