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NPI Code Detail

MEDICARE: JAMES E BUSH LCSW

MEDICARE: JAMES E BUSH LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker34003090AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780630483
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES E BUSH LCSW
Provider Business Mailing Address
First Line : 645 S ROGERS ST
Second Line :
City : BLOOMINGTON
State : IN
Zip : 47403-2353
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1525 N RITTER AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-3026
Country : US
Telephone Number : 317-322-4087
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2006
Last Update Date : 09/16/2025

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