Alexander Busch, PHD
Individual provider Active NPI Clinical Psychologist · Charleston, SC
NPI 1821753369 · NPPES record last updated Aug 15, 2024
Key facts
- NPI
- 1821753369
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 1686 (SC)
- Practice address
- 334 E Bay St # 233
Charleston, SC 29401-1592 - Phone
- (630) 748-9570
- NPI assigned
- Oct 31, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220419000535 | SC | Practitioner - Clinical Psychologist | 2466849625 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Medical Associates of the Medical University of South Carol | Current |
Accepting new patients | |
| University Medical Associates of the Medical University of South Carol | Current |
Accepting new patients |
Locations
67 President St
Ofc 506H
Charleston, SC 29425
171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1686 | SC | Yes |
Addresses
Primary practice location
334 E Bay St # 233
Charleston, SC 29401-1592
Mailing address
334 E Bay St # 233
Charleston, SC 29401-1592
Phone (630) 748-9570
Other providers in Charleston, SC
- Richard Harris Burton Jr.
- Tasha Burton
- Courtney Madisen Burwell
- Shannon Dare Busby
- Stephen Clark Busby
- Carrie Elizabeth Busch
- Robert Buschur
- Arenilla K Bush
- Jeffrey Sullivan Bush
- Samantha Bush
All providers in Charleston, SC · Clinical Psychologist in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.