Lisa Renee Bush
Individual provider Active NPI Social Worker · Harrison, MI
NPI 1689095358 · NPPES record last updated Dec 26, 2013
Key facts
- NPI
- 1689095358
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 6802085846 (MI)
- Practice address
- 789 N Clare Ave
Harrison, MI 48625-9194 - Phone
- (989) 539-2141
- Fax
- (989) 539-2143
- NPI assigned
- Dec 26, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6802085846 | MI | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6802085846 | MI | Yes |
Addresses
Primary practice location
789 N Clare Ave
Harrison, MI 48625-9194
Mailing address
789 N Clare Ave
PO Box 817
Harrison, MI 48625-9194
Phone (989) 539-2141
Other providers in Harrison, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 26, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.