Provider Demographics
NPI:1568049062
Name:BUSH, DANIEL J (PHD, MA, MDIV, LPCC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:J
Last Name:BUSH
Suffix:
Gender:M
Credentials:PHD, MA, MDIV, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10228 HEMPSTEADE DR
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:KY
Mailing Address - Zip Code:41091-9484
Mailing Address - Country:US
Mailing Address - Phone:513-504-6691
Mailing Address - Fax:
Practice Address - Street 1:73 CAVALIER BLVD STE 320
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-5185
Practice Address - Country:US
Practice Address - Phone:859-935-0110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health