Individual provider Active NPI

Kelly E Bartle-Bush, LCSW

  • Clinical Social Worker
  • Horseheads, NY
National Provider Identifier
1750628111
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
902 W Broad St
Horseheads, NY 14845-2254
Phone
(607) 252-4519
NPI assigned
Jan 4, 2013
Last updated
Jun 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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 Primary

Addresses

Primary practice location

902 W Broad St
Horseheads, NY 14845-2254

Mailing address

902 W Broad St
Horseheads, NY 14845-2254
Phone (607) 252-4519

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20180718001775 NY Practitioner - Clinical Social Worker 0244587574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4 Prospect St
Seneca Falls, NY 13148-1214

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
086282NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
Presence Sealy Counseling and Development Licensedclinicalservicespllc Clinical CurrentSince Oct 8, 2019 Accepting new patients
Nurtured Beginnings LCSW Therapy, PLLC Clinical CurrentSince Oct 1, 2023 Accepting new patients
Presence Psychology, LMSW, PT, OT and SLP Services, PLLC CurrentSince Apr 18, 2019 Accepting new patients

Locations

115 Fall St
Seneca Falls, NY 13148
Phone (315) 515-5183

Interoperability endpoints

  • Direct secure messaging: kellybartlebush@tdh.allscriptsdirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1357257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1750628111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 W BROAD ST",
            "city": "HORSEHEADS",
            "state": "NY",
            "postal_code": "148452254",
            "telephone_number": "607-252-4519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 W BROAD ST",
            "city": "HORSEHEADS",
            "state": "NY",
            "postal_code": "148452254",
            "telephone_number": "607-252-4519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTLE-BUSH",
        "first_name": "KELLY",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-04",
        "last_updated": "2022-06-06",
        "certification_date": "2020-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Horseheads, NY

Sources for this page

Verify at the official NPI Registry.