Individual provider Active NPI

Daniel J Bush, PHD, MA, MDIV, LPCC

  • Mental Health Counselor
  • Florence, KY
National Provider Identifier
1568049062
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
283449 Issued in KY
Practice address
75 Cavalier Blvd Ste 212
Florence, KY 41042-3958
Phone
(859) 935-0110
NPI assigned
Mar 29, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 283449 KY Primary

Addresses

Primary practice location

75 Cavalier Blvd Ste 212
Florence, KY 41042-3958

Mailing address

75 Cavalier Blvd Ste 212
Florence, KY 41042-3958
Phone (513) 339-6396

Other identifiers 1

IdentifierTypeStateIssuer
7101012000MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241115004055 KY Practitioner - Mental Health Counselor 2567996267 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

75 Cavalier Blvd
Suite 212
Florence, KY 41042-3958
Phone (859) 935-0110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Everglade Psychotherapy Group LLC CurrentSince Oct 31, 2024 Accepting new patients
Stillwaters Relational and Behavioral Health PLLC Mental Health CurrentSince Sep 23, 2025 Accepting new patients

Locations

73 Cavalier Blvd
Ste 321
Florence, KY 41042
Phone (513) 341-5241

75 Cavalier Blvd
Ste 212
Florence, KY 41042
Phone (513) 339-6396

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": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1568049062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 CAVALIER BLVD STE 212",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410423958",
            "telephone_number": "513-339-6396",
            "fax_number": "111-111-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 CAVALIER BLVD STE 212",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410423958",
            "telephone_number": "859-935-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "DANIEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PHD, MA, MDIV, LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-29",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "283449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7101012000",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, KY

Sources for this page

Verify at the official NPI Registry.