BUSH COUNSELING SERVICE LCSW PLLC NPI 1467093054

NPI Information

  • NPI: 1467093054
  • Provider Name: BUSH COUNSELING SERVICE LCSW PLLC
  • Classification: Social Worker - 1041C0700X
  • Specialization: Clinical
  • Entity Type: Organization
  • Address: 4673 STATE HIGHWAY 58
    GOUVERNEUR, NY
    ZIP 13642
  • Phone: (386) 888-6464

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NPI Details

BUSH COUNSELING SERVICE LCSW PLLC is a clinical social worker in Gouverneur, NY. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. BUSH COUNSELING SERVICE LCSW PLLC NPI is 1467093054. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4673 STATE HIGHWAY 58
GOUVERNEUR, NY
ZIP 13642-202
Phone: (386) 888-6464
Fax: (386) 888-6465

The provider's authorized official is Selena Bush .
The authorized official title is Owner and has the following contact phone number (386) 888-6464.

The enumeration date for this NPI number is 10/4/2019 and was last updated on 12/21/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11041C0700XSocial WorkerClinicalYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
105620695MEDICAIDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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