Individual provider Active NPI

Shana Bush

  • Clinical Social Worker
  • Lansing, MI
National Provider Identifier
1497294185
Registry record updated Feb 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801099468 Issued in MI
Practice address
4902 S Cedar St
Lansing, MI 48910-5474
Phone
(517) 394-7867
NPI assigned
Feb 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801099468 MI Primary

Addresses

Primary practice location

4902 S Cedar St
Lansing, MI 48910-5474

Mailing address

4902 S Cedar St
Lansing, MI 48910-5474
Phone (517) 394-7867

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

LicenseStateTypeSpecialty
6801099468MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Zenlightenment Wellness Center LLC Clinical CurrentSince Sep 23, 2021 Accepting new patients
Victory Clinical Services Lansing PastSince Mar 2, 2015 Accepting new patients

Locations

110 E Superior St
Alma, MI 48801
Phone (989) 285-1818

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1487116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487116800000",
    "number": "1497294185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4902 S CEDAR ST",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489105474",
            "telephone_number": "517-394-7867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4902 S CEDAR ST",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489105474",
            "telephone_number": "517-394-7867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "SHANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-15",
        "last_updated": "2017-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801099468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

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

Verify at the official NPI Registry.