Mary Lu Bushnell, PSY.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

3900 Issued in AZ

Practice address

650 E Indian School Rd # 116B
Phoenix, AZ 85012-1839

Phone

(602) 277-5551

NPI assigned

Sep 9, 2007

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

Other names 1

• Miss Mary Lu Wylie Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1189296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189296000000",
    "number": "1861687360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 E INDIAN SCHOOL RD # 116B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121839",
            "telephone_number": "602-277-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 E INDIAN SCHOOL RD # 116B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121839",
            "telephone_number": "602-277-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHNELL",
        "first_name": "MARY",
        "middle_name": "LU",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-09",
        "last_updated": "2007-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AZ",
            "license": "3900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "WYLIE",
            "middle_name": "LU",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sarah Bushbaum, BS, DTR
• Eric Steven Bushman, O.D
• Ivan Scott Bushman, RN
• Monique Lynne Bushman, M.D.
• Teresa Renee Bushman
• Elby Bushong IV
• Suzanne Bushong
• Andrea Busicescu, MD
• Spencer Charles Busler, MSN, APRN, AGACNP-BC
• Kaitlin Buss, PA-C

• Clinical Neuropsychologist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Clinical Neuropsychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2007; 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.