| Bush Counseling Service Lcsw Pllc | |
|
4673 State Highway 58 Gouverneur NY 13642-3202 | |
| (386) 888-6464 | |
| (386) 888-6465 |
| Full Name | Bush Counseling Service Lcsw Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4673 State Highway 58, Gouverneur, New York |
| Authorized Official Name and Position | Selena Bush (OWNER) |
| Authorized Official Contact | 3868886464 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bush Counseling Service Lcsw Pllc 4673 State Highway 58 Gouverneur NY 13642-3202 Ph: (386) 888-6464 | Bush Counseling Service Lcsw Pllc 4673 State Highway 58 Gouverneur NY 13642-3202 Ph: (386) 888-6464 |
| NPI Number | 1467093054 |
|---|---|
| Provider Enumeration Date | 10/04/2019 |
| Last Update Date | 12/21/2020 |
| Certification Date | 12/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467093054 | NPI | - | NPPES |
| 05620695 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Lightwork Therapy, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 264 W Main St, Gouverneur, NY 13642 Phone: 315-753-8710 | |
St. Lawrence Psychiatric Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 28 William St, Gouverneur, NY 13642 Phone: 315-287-2811 Fax: 315-287-4743 | |
St. Lawrence Psychiatric Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 28 William St, Gouverneur, NY 13642 Phone: 315-287-2811 |