Bush, Crystal D

Bush, Crystal D is an sole proprietor health care provider with primary practice located at 1235 S Scales St , Reidsville NC 27320-5630. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Bush, Crystal D can be contacted via phone (199) 539-8520.

Contact Information

Primary practice address
1235 S Scales St Reidsville NC 27320-5630
Phone: (199) 539-8520
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 1615 North Carolina
Behavioral Health & Social Service Providers / Clinical 1041C0700X South Carolina
Behavioral Health & Social Service Providers / Clinical 1041C0700X C006358 North Carolina

Profile Details

NPI number 1265532527
LBN Legal business name Bush, Crystal D
Credentials LCSW, LCAS, LISW-CP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 25th, 2006
Last updated Apr 3rd, 2024 - about 7 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265532527 NPPES
North Carolina Other SS# TRICARE
North Carolina MEDICAID 6007277 TRICARE
North Carolina Other 156NM TRICARE

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