Debra Mae Haworth-Bush, CADC,CPRC,CPSS,CFSP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

12953 Issued in ID

Practice address

30410 Highway 200 Ste 200
Ponderay, ID 83852-9601

Phone

(208) 263-7101

NPI assigned

Sep 15, 2021

Last updated

Sep 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: debra.haworthbushcadc.p1@direct.kch.nextgenshare.com

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1801566484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2160",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838640908",
            "telephone_number": "208-263-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30410 HIGHWAY 200 STE 200",
            "city": "PONDERAY",
            "state": "ID",
            "postal_code": "838529601",
            "telephone_number": "208-263-7101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6509 Highway 2 Ste 101",
            "address_purpose": "LOCATION",
            "city": "Priest River",
            "state": "ID",
            "postal_code": "838566609",
            "country_code": "US",
            "telephone_number": "208-448-2321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAWORTH-BUSH",
        "first_name": "DEBRA",
        "middle_name": "MAE",
        "credential": "CADC,CPRC,CPSS,CFSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ID",
            "license": "12953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Ponderay, ID
• Providers in Ponderay, ID by specialty
• Addiction (Substance Use Disorder) Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; 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.